J7320 HCPCS code: Hyaluronan or derivitive, genvisc 850, for intra-articular injection, 1 mg
J7320 is the HCPCS Level II code for hyaluronan or derivitive, genvisc 850, for intra-articular injection, 1 mg. In 2024 Medicare paid an average of $4.23 per service for J7320 across 3,895,844 services. Its Medicare coverage code is C (Carrier judgment): Coverage is decided by the Medicare contractor (MAC) case by case. The NCCI unit limit is 50 per day on outpatient hospital claims. Medicare volume fell 39% from 2022 to 2024 (6,424,372 to 3,895,844 services). In 2024, about 1,114 clinicians billed Medicare for J7320 for 20,472 beneficiaries; Illinois, New York, California accounted for 39% of services.
Code details
| Field | Value |
|---|---|
| Section | J codes — Drugs administered other than oral method |
| Coverage code | C — Carrier judgment |
| Pricing indicator | 51 — Drug or biological (priced per ASP/average sales price rules) |
| BETOS category | O1E — Other drugs |
| Added | 2017-01-01 |
| Last action effective | 2018-01-01 |
Who bills J7320 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 1,114 |
| Medicare beneficiaries | 20,472 |
| States with claims | 35 |
| Share of services in top 3 states (Illinois, New York, California) | 39% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J7320, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 6,424,372 | 40,088 | $14.84 | $11.80 |
| 2023 | 4,596,422 | 25,366 | $7.06 | $5.58 |
| 2024 | 3,895,844 | 20,472 | $5.37 | $4.23 |
States with the most J7320 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Illinois | 791,350 | $4.27 |
| New York | 395,668 | $4.22 |
| California | 339,985 | $4.22 |
| Texas | 319,498 | $4.21 |
| New Jersey | 319,378 | $4.23 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 50 | Prescribing Information |
| practitioner claims | 50 | Prescribing Information |
Medicare policy articles for this code
- A52420: Billing and Coding: Hyaluronans Intra-articular Injections of (Wellpoint Federal (MAC - Part A, MAC - Part B))
- A56157: Billing and Coding: Intraarticular Knee Injections of Hyaluronan (WPS Insurance Corporation (MAC - Part A, MAC - Part B))
- A59030: Billing and Coding: Hyaluronic Acid Injections for Knee Osteoarthritis (Palmetto GBA (MAC - Part A, MAC - Part B))
Covered diagnoses (17 ICD-10-CM codes)
The diagnoses most often listed as covered in the policy articles above:
| ICD-10-CM | Diagnosis | Articles listing it |
|---|---|---|
| M17.0 | Bilateral primary osteoarthritis of knee | 3 |
| M17.11 | Unilateral primary osteoarthritis, right knee | 3 |
| M17.12 | Unilateral primary osteoarthritis, left knee | 3 |
| M17.2 | Bilateral post-traumatic osteoarthritis of knee | 3 |
| M17.31 | Unilateral post-traumatic osteoarthritis, right knee | 3 |
| M17.32 | Unilateral post-traumatic osteoarthritis, left knee | 3 |
| M17.4 | Other bilateral secondary osteoarthritis of knee | 3 |
| M17.5 | Other unilateral secondary osteoarthritis of knee | 3 |
| M17.9 | Osteoarthritis of knee, unspecified | 1 |
| M19.011 | Primary osteoarthritis, right shoulder | 1 |
Showing 10 of 17. The full list, non-covered diagnoses and CSV export are in Caduvo.
What changed for J7320
- 2017-01-01: J7320 added to HCPCS Level II
- Next scheduled CMS quarterly update (HCPCS and DMEPOS fee schedule): 2027-01-01
Frequently asked questions
What is HCPCS code J7320?
J7320 is the HCPCS Level II code for hyaluronan or derivitive, genvisc 850, for intra-articular injection, 1 mg. Short descriptor: "Genvisc 850, inj, 1mg".
How much does Medicare pay for J7320?
In 2024, the average Medicare payment was $4.23 per service (average allowed $5.37).
Does Medicare cover J7320?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Which diagnoses support coverage for J7320?
Medicare policy articles that cite J7320 list 17 covered ICD-10-CM diagnosis codes across 3 articles. The most cited include M17.0 (Bilateral primary osteoarthritis of knee), M17.11 (Unilateral primary osteoarthritis, right knee), M17.12 (Unilateral primary osteoarthritis, left knee). A listed diagnosis is necessary but not sufficient; the policy's other criteria still apply.
How many units of J7320 can be billed per day?
50 on outpatient hospital claims; 50 on practitioner claims (NCCI medically unlikely edits).
Related J73 codes
- J7300 — Intrauterine copper contraceptive (paragard)
- J7301 — Levonorgestrel-releasing intrauterine contraceptive system (skyla), 13.5 mg
- J7302 — Levonorgestrel-releasing intrauterine contraceptive system, 52 mg
- J7303 — Contraceptive supply, hormone containing vaginal ring, each
- J7304 — Contraceptive supply, hormone containing patch, each
- J7306 — Levonorgestrel (contraceptive) implant system, including implants and supplies
- J7307 — Etonogestrel (contraceptive) implant system, including implant and supplies
- J7308 — Aminolevulinic acid hcl for topical administration, 20%, single unit dosage form (354 mg)
- J7309 — Methyl aminolevulinate (mal) for topical administration, 16.8%, 1 gram
- J7310 — Ganciclovir, 4.5 mg, long-acting implant
- J7311 — Injection, fluocinolone acetonide, intravitreal implant (retisert), 0.01 mg
- J7312 — Injection, dexamethasone, intravitreal implant, 0.1 mg
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Next steps
- Run a reimbursement report for a device billed under J7320
- Watch J7320 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J7320
Sources: CMS HCPCS Level II release October 2025; CMS DMEPOS fee schedule; CMS NCCI MUE tables; CMS Medicare utilization (physician and DME supplier files); CMS Medicare Coverage Database articles. Fees are Medicare allowables, not commercial rates. Not billing or legal advice.