RxDoctor Payments Data

HCPCS J7318

Hyaluronan or derivative, durolane, for intra-articular injection, 1 mg

$6.47Medicare-allowed amount per service, averaged across 3,779,716 services
Providers submitted
$31.14

Asking price, not received

Medicare allowed
$6.47

The fee schedule figure

Medicare paid
$5.08

Balance is patient coinsurance

Providers submitted an average of $31.14 for this code and Medicare allowed $6.474.8× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $5.08 (79%); the rest is the patient’s coinsurance and deductible.

Services
3,779,716

Medicare Part B, 2024

Beneficiaries
41,331
Providers billing it
1,475
Total allowed
$24,454,763

Services × allowed amount

What Medicare pays for HCPCS J7318

Across 3,779,716 services billed by 1,475 providers to 41,331 beneficiaries, Medicare allowed an average of $6.47 per service. That is 91.4 services per beneficiary, so this is a code patients typically receive more than once. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

This is a drug or supply code rather than a service. The unit is usually a dose or a milligram, so the per-service figure is small by construction and the total is what carries meaning — read it alongside the service count rather than on its own.

Who bills J7318

SpecialtyServicesBeneficiariesAvg allowedProviders
Orthopedic Surgery1,693,54018,752$6.46661
Physician Assistant1,007,38611,212$6.48414
Sports Medicine371,9293,908$6.47131
Nurse Practitioner261,5122,845$6.4692
Family Practice224,6432,225$6.4971
Physical Medicine and Rehabilitation108,1921,147$6.4652
Internal Medicine42,302419$6.5113
Rheumatology25,264256$6.4214
Emergency Medicine14,880169$6.587
Pain Management8,463146$6.437
Pediatric Medicine6,30072$6.443
General Surgery2,94028$6.481
Osteopathic Manipulative Medicine2,70033$6.492
General Practice2,40031$6.561
Hand Surgery2,10129$6.472

J7318 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

StateServicesAllowedStandardized pmtProviders
California459,089$6.49$5.12137
South Carolina267,092$6.43$5.1390
Texas229,798$6.47$5.09103
Florida210,518$6.44$5.0868
North Carolina203,850$6.47$5.1493
Illinois180,475$6.45$5.1166
Arizona173,635$6.45$5.0776
New Jersey164,083$6.37$5.0651
New York159,118$6.49$5.1577
Ohio155,934$6.46$5.0866
Kentucky146,601$6.46$5.1151
Virginia138,031$6.48$5.1151
Michigan137,946$6.48$5.1251
Colorado133,467$6.49$5.1161
Alabama131,721$6.53$5.2232
Mississippi118,323$6.46$5.1440
Pennsylvania118,129$6.47$5.0652
Massachusetts90,521$6.49$5.0734
Tennessee70,332$6.51$5.1429
Connecticut47,946$6.47$5.0528
Georgia44,953$6.47$5.0723
Wisconsin40,235$6.44$5.1019
Oklahoma40,051$6.45$5.1219
Maryland37,142$6.45$5.1521
New Hampshire33,862$6.51$5.1412
Rhode Island28,553$6.50$5.1515
Arkansas28,546$6.47$5.0910
Oregon28,040$6.42$5.0013
Wyoming21,180$6.50$5.0614
Missouri18,735$6.49$5.118
Hawaii16,571$6.54$5.069
New Mexico16,204$6.53$5.175
Indiana12,780$6.56$5.208
Nevada11,730$6.43$5.178
Kansas11,585$6.48$5.057
Minnesota7,741$6.48$5.195
Nebraska7,680$6.51$5.092
Iowa7,322$6.53$5.124
Washington6,420$6.57$5.223
Idaho4,860$6.49$5.072
Louisiana4,574$6.54$5.093
Utah4,140$6.50$5.083
West Virginia3,540$6.54$5.152
Maine2,760$6.43$5.062
District of Columbia2,283$6.34$5.051
Montana1,620$6.32$4.951

Related codes

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.