J7328 HCPCS code: Hyaluronan or derivative, gelsyn-3, for intra-articular injection, 0.1 mg
J7328 is the HCPCS Level II code for hyaluronan or derivative, gelsyn-3, for intra-articular injection, 0.1 mg. In 2024 Medicare paid an average of $0.40 per service for J7328 across 11,420,478 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 336 per day on outpatient hospital claims. Medicare volume fell 29% from 2022 to 2024 (16,186,311 to 11,420,478 services). In 2024, about 3,162 clinicians billed Medicare for J7328 for 16,071 beneficiaries; California, Texas, New York accounted for 31% 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 | 2016-01-01 |
| Last action effective | 2018-01-01 |
Who bills J7328 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 3,162 |
| Medicare beneficiaries | 16,071 |
| States with claims | 41 |
| Share of services in top 3 states (California, Texas, New York) | 31% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J7328, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 16,186,311 | 22,914 | $1.91 | $1.51 |
| 2023 | 13,062,979 | 18,212 | $0.69 | $0.54 |
| 2024 | 11,420,478 | 16,071 | $0.52 | $0.40 |
States with the most J7328 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| California | 1,527,845 | $0.41 |
| Texas | 988,998 | $0.40 |
| New York | 985,819 | $0.41 |
| Florida | 971,748 | $0.40 |
| Illinois | 892,501 | $0.40 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 336 | Prescribing Information |
| practitioner claims | 336 | Prescribing Information |
Medicare policy articles for this code
- A52420: Billing and Coding: Hyaluronans Intra-articular Injections of (National Government Services, Inc. (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 J7328
- 2016-01-01: J7328 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 J7328?
J7328 is the HCPCS Level II code for hyaluronan or derivative, gelsyn-3, for intra-articular injection, 0.1 mg. Short descriptor: "Gelsyn-3 injection 0.1 mg".
How much does Medicare pay for J7328?
In 2024, the average Medicare payment was $0.40 per service (average allowed $0.52).
Does Medicare cover J7328?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Which diagnoses support coverage for J7328?
Medicare policy articles that cite J7328 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 J7328 can be billed per day?
336 on outpatient hospital claims; 336 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 J7328
- Watch J7328 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J7328
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.