Home › Drug Codes › J Codes › J7313 · ILUVIEN
Updated July 1st, 2026

ILUVIEN J Code: J7313

Injection, fluocinolone acetonide, intravitreal implant (iluvien), 0.01 mg

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Q4 2026 Medicare Payment Limit for J7313, effective October 1, 2026: $516.516 per HCPCS billing unit, unchanged from Q3 2026. From CMS's final file.

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Medicare Payment Limit ?
$516.406
/ HCPCS billing unit · Q3 2026
APC Payment Limit ?
$516.406
/ HCPCS billing unit · APC 9450
ASP ?
$•••.••
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WAC · AWP ?
$•••.••
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NDCs Crosswalked ?
1
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Drug & Product Overview

HCPCS Descriptor Injection, fluocinolone acetonide, intravitreal implant (iluvien), 0.01 mg
HCPCS Added Date January 1, 2016
Manufacturer ANI Pharmaceuticals, Inc
Route of Administration Intravitreal
Generic Status Single-Source; Branded
Dosage Type Single-Dose
Dosage Form Implant

About ILUVIEN

Iluvien is a medication aligned to the HCPCS J Code: J7313 for billing, pricing, and reimbursement purposes in the United States. Classified under Ophthalmology, it is administered via the intravitreal route and manufactured by ANI Pharmaceuticals, Inc.

According to CMS Drug Use Information: Drug uses not available

Disclaimer: This is a summary and does not contain all possible information about this product. For complete information about this product or your specific health needs, ask your healthcare professional.

NDC Code Information

Based on publicly available CMS files. The list of NDCs below is not exhaustive.

NDC Code Drug Manufacturer Billing Units / Pkg Package Size
68611-0190-02 Iluvien ANI Pharmaceuticals, Inc. 19 .19 MG
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ILUVIEN Pricing & Reimbursement

J7313 Private Payer Reimbursement
$507.33 / HCPCS unit as of Jan 2026

National median reimbursement across major commercial payers.

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UnitedHealthcare, BlueCross BlueShield, Aetna, Cigna

Historical Graphing and Billing Calculator

per HCPCS unit
As of Q3 2026

ILUVIEN CPT Administration Codes

The below list of CPT codes is intended for informational purposes only and may not be exhaustive. CPT® codes and descriptions are copyright American Medical Association (AMA). All rights reserved.

CPT Code Description
67028 Intravitreal injection of a pharmacologic agent (separate procedure) 67028
JW / JZ modifiers apply

CMS has identified Iluvien (J7313) as a HCPCS code with single-dose containers. Therefore, the JW/JZ wastage modifiers could be required for billing purposes. Wastage billing guide →

ILUVIEN Medically Unlikely Edits (MUE)

The most billing units of J7313 Medicare will pay for one patient in one day, as published by CMS. 1 unit = 0.01 mg.

Practitioner Office & Hospital Outpatient
38 units / day
= 0.38 mg per day

MAI 2 · Date of Service Edit: Policy. Absolute per-day limit set by policy or regulation; units above it are not payable, and denials are not appealable on medical-necessity grounds. See all MUE limits →

mg Enter a dose to see how many billing units it is and whether it is under the limit.

ILUVIEN Clinical Information

Indications and drug classification.

Treated Diseases & Conditions

This list of indications is not exhaustive and may be subject to errors. The information on BuyandBill.com is intended for informational purposes only and should not be used for medical advice.

Chronic Non-Infectious Uveitis Affecting the Posterior Segment Diabetic Macular Edema
Drug Class
Corticosteroid Hormone Receptor Agonists [MoA]Corticosteroid [EPC]

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Frequently Asked Questions

Is there an available Iluvien billing and coding guide?
Billing and coding information for ILUVIEN can be found through Alimera Sciences. Visit Here →
Are there any available Iluvien patient assistance programs?
ILUVIEN patient assistance information can be found through Alimera Sciences. Visit Here →
Where can I find Iluvien prescribing information?
ILUVIEN prescribing information can be found at the link below: Visit Here →
Where can I find Iluvien side effect information?
Our team has not yet identified a source of side effects information for ILUVIEN. Please check back in a few weeks.
Does billing ILUVIEN require JZ/JW wastage modifiers?
CMS has identified ILUVIEN(J7313) as a HCPCS code with single-dose containers. Therefore, the JW/JZ wastage modifiers could be required for billing purposes. See CMS guidelines on use of the JZ and JW wastage modifiers below.

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