J7326 HCPCS code: Hyaluronan or derivative, gel-one, for intra-articular injection, per dose
J7326 is the HCPCS Level II code for hyaluronan or derivative, gel-one, for intra-articular injection, per dose. In 2024 Medicare paid an average of $401.10 per service for J7326 across 101,420 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 2 per day on outpatient hospital claims. Medicare volume fell 21% from 2022 to 2024 (128,268 to 101,420 services). In 2024, about 5,597 clinicians billed Medicare for J7326 for 62,638 beneficiaries; New Jersey, Florida, Illinois accounted for 32% 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 | 2012-01-01 |
| Last action effective | 2017-01-01 |
Who bills J7326 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 5,597 |
| Medicare beneficiaries | 62,638 |
| States with claims | 49 |
| Share of services in top 3 states (New Jersey, Florida, Illinois) | 32% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J7326, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 128,268 | 82,778 | $918.25 | $729.84 |
| 2023 | 106,975 | 66,991 | $508.46 | $401.62 |
| 2024 | 101,420 | 62,638 | $509.08 | $401.10 |
States with the most J7326 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| New Jersey | 12,395 | $403.17 |
| Florida | 11,364 | $400.46 |
| Illinois | 8,416 | $401.05 |
| New York | 8,219 | $401.05 |
| Pennsylvania | 7,633 | $401.16 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 2 | Anatomic Consideration |
| practitioner claims | 2 | Anatomic Consideration |
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 J7326
- 2012-01-01: J7326 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 J7326?
J7326 is the HCPCS Level II code for hyaluronan or derivative, gel-one, for intra-articular injection, per dose. Short descriptor: "Gel-one".
How much does Medicare pay for J7326?
In 2024, the average Medicare payment was $401.10 per service (average allowed $509.08).
Does Medicare cover J7326?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Which diagnoses support coverage for J7326?
Medicare policy articles that cite J7326 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 J7326 can be billed per day?
2 on outpatient hospital claims; 2 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
Building a device that would bill under a code like this? Caduvo matches a device description to HCPCS/CPT codes, Medicare coverage and payment, and the FDA pathway in one report.
Next steps
- Run a reimbursement report for a device billed under J7326
- Watch J7326 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J7326
Sources: CMS HCPCS Level II release October 2026; 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.