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HCPCS J7310 Fee Schedule

Last Verified: January 2026

Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.

Ganciclovir, 4.5 mg, long-acting implant
Key FactDetail
Service Type

Drugs Administered Other than Oral Method

Miscellaneous Drugs

Common Place of Service

None

11 - Office

Complexity LevelHigh

National average reimbursement for HCPCS J7310 by major payers:

bcbs

$6,605.82

uhc

$19,418.22

aetna

$8,385.94

cigna

$17,757.49

Preview provider-level rates for...
For billing codeHCPCS J7310
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for HCPCS J7310

United
J7310$26688.001629167457 - COUNTY OF VENTURA, VENTURA COUNTY MEDICAL CENTER956000944CAGeneral Acute Care Hospital (282N00000X)
United
J7310$20352.001578664470 - SUNNYVIEW HOSPITAL AND REHABILITATION CENTER, SUNNYVIEW REHABILITATION HOSPITAL141338386 - (NY) SUNNYVIEW HOSPITAL AND REHABILITATION CENTERNYGeneral Acute Care Hospital (282N00000X)
United
J7310$19200.001588614325 - ST. CLOUD VAMC411768149MNGeneral Acute Care Hospital (282N00000X)
United
J7310$21389.951851768337 - KELLY RIDGES362925195 - ALLERGY & ASTHMA OF DUPAGE, S.C.ILFamily Nurse Practitioner (363LF0000X)
United
J7310$19200.001528079753 - BON SECOURS ST. MARY'S HOSPITAL OF RICHMOND LLC, BON SECOURS ST MARY'S HOSPITAL OF RICHMOND PRO FEE SERVICES540793767 - (VA) BON SECOURS ST MARYS HOSPITAL OF RICHMOND LLCVAGeneral Acute Care Hospital (282N00000X)
United
J7310$19200.001659340370 - SKY LAKES MEDICAL CENTER INC930508781 - SKY LAKES MEDICAL CENTER INCORGeneral Acute Care Hospital (282N00000X)
United
J7310$19975.671245324581 - SATURNINO HERRERA270444414 - (NJ) GARDEN STATE HEALTHCARE ASSOCIATES, LLCNJGeneral Acute Care Hospital (282N00000X)
United
J7310$6969.891962455816 - CHCA CONROE LP, CONROE REGIONAL MEDICAL CENTER621801361 - (TX) CHCA CONROE LPTXGeneral Acute Care Hospital (282N00000X)
United
J7310$19200.001912038811 - KING'S DAUGHTERS MEDICAL CENTER610444716 - ASHLAND HOSPITAL CORPORATIONMSGeneral Acute Care Hospital (282N00000X)
United
J7310$19200.001033174933 - KING COUNTY PUBLIC HOSPITAL DISTRICT NO. 2, EVERGREENHEALTH MEDICAL CENTER910844563WAGeneral Acute Care Hospital (282N00000X)
United
J7310$20352.001407016488 - RAN SCHWARZKOPF132655001 - NEW YORK CITY HEALTH AND HOSPITALS CORPORATIONCAGeneral Acute Care Hospital (282N00000X)
United
J7310$12691.201285707091 - LASZLO OSVATH132655001 - NEW YORK CITY HEALTH AND HOSPITALS CORPORATIONNYGeneral Acute Care Hospital (282N00000X)
United
J7310$19200.001447218235 - COMMUNITY HOSPITAL630047680 - (AL) COMMUNITY HOSPITAL INCALGeneral Acute Care Hospital (282N00000X)
United
J7310$19200.001598839789 - ST. CHARLES MEDICAL CENTER930602940 - ST CHARLES HEALTH SYSTEM INCORGeneral Acute Care Hospital (282N00000X)
United
J7310$19200.001811034291 - ST. BERNARD HOSPITAL362264414 - (IL) ST BERNARD HOSPITALILGeneral Acute Care Hospital (282N00000X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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HCPCS J7310 vs. Other Miscellaneous Drugs Codes

The HCPCS J7310 code is part of the Drugs Administered Other than Oral Method services used for Miscellaneous Drugs. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.

The HCPCS J7310 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.

CodeComplexityDescription
J7309-HCPCSLowMethyl aminolevulinate (MAL) for topical administration, 16.8%, 1 gram
J7310-HCPCSHighGanciclovir, 4.5 mg, long-acting implant
J7311-HCPCSModerateInjection, fluocinolone acetonide, intravitreal implant (retisert), 0.01 mg

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS J7310. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the J7310 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.

Factors that affect fee schedules


Medicare & Medicaid Rates

Government-set reimbursement amounts


Private Insurance Rates

Negotiated rates between providers and insurance companies


Geographic Location

Costs may be higher in urban areas.


Provider Type

Hospital providers may have different rates than private practice.

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