How much does Medicare pay for HCPCS J7320?

Medicare allowed an average of $5.37 per service and paid $4.23 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $21.78, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is HCPCS code J7320?

Hyaluronan or derivitive, genvisc 850, for intra-articular injection, 1 mg. It was billed 3,633,116 times to 24,804 Medicare beneficiaries by 347 providers in 2024.

Does J7320 pay differently in an office than a hospital?

Yes. The allowed amount averaged $5.37 in an office setting and $5.39 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills J7320 most?

Family Practice, with 693,316 services from 21 clinicians. Next are Physical Medicine and Rehabilitation, Orthopedic Surgery, Nurse Practitioner.

HCPCS J7320

Hyaluronan or derivitive, genvisc 850, for intra-articular injection, 1 mg

$5.37Medicare-allowed amount per service, averaged across 3,633,116 services

Providers submitted

$21.78

Asking price, not received

Medicare allowed

$5.37

The fee schedule figure

Medicare paid

$4.23

Balance is patient coinsurance

Providers submitted an average of $21.78 for this code and Medicare allowed $5.37 — 4.1× 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 $4.23 (79%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $5.37
Hospital / facility: $5.39

The facility rate is higher for this code, which is unusual and generally means the service depends on equipment or staffing a hospital carries. 3,615,689 services were billed in an office setting and 17,427 in a facility.

Services: 3,633,116
Beneficiaries: 24,804
Providers billing it: 347
Total allowed: $19,509,833

What Medicare pays for HCPCS J7320

Across 3,633,116 services billed by 347 providers to 24,804 beneficiaries, Medicare allowed an average of $5.37 per service. That is 146.5 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 J7320

Specialty	Services	Beneficiaries	Avg allowed	Providers
Family Practice	693,316	4,216	$5.39	21
Physical Medicine and Rehabilitation	567,442	3,841	$5.38	39
Orthopedic Surgery	394,183	2,858	$5.41	49
Nurse Practitioner	279,226	2,192	$5.38	66
Emergency Medicine	263,253	1,842	$5.39	11
Physician Assistant	238,812	2,768	$5.39	48
Internal Medicine	193,993	998	$5.33	10
General Practice	153,378	815	$5.35	6
Pain Management	152,849	1,134	$5.31	28
Plastic and Reconstructive Surgery	137,650	716	$5.34	3
Vascular Surgery	132,926	597	$5.38	1
General Surgery	77,210	359	$5.39	1
Sports Medicine	76,157	539	$5.29	8
Interventional Pain Management	61,798	459	$5.35	12
Anesthesiology	61,463	441	$5.31	17

J7320 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.

State	Services	Allowed	Standardized pmt	Providers
Illinois	776,152	$5.38	$4.28	31
New York	374,357	$5.38	$4.22	34
California	308,837	$5.36	$4.23	30
Texas	294,110	$5.36	$4.22	26
New Jersey	293,885	$5.36	$4.23	36
Kentucky	209,525	$5.39	$4.20	9
Arizona	201,458	$5.43	$4.22	22
Florida	194,124	$5.41	$4.28	37
Ohio	144,075	$5.37	$4.19	5
South Carolina	140,654	$5.34	$4.19	14
Georgia	118,602	$5.36	$4.21	17
North Carolina	95,752	$5.39	$4.26	7
Pennsylvania	85,760	$5.39	$4.20	3
Puerto Rico	60,950	$5.32	$4.14	1
Hawaii	45,200	$5.40	$4.23	2
Virginia	41,005	$5.31	$4.18	7
Colorado	36,477	$5.43	$4.28	6
Michigan	32,346	$5.36	$4.23	10
Oregon	32,055	$5.38	$4.21	6
Minnesota	27,000	$5.25	$4.18	3
Maryland	22,550	$5.38	$4.26	12
Missouri	20,625	$5.41	$4.27	7
Tennessee	10,632	$5.36	$4.18	3
Washington	8,675	$5.37	$4.14	3
Alabama	8,575	$5.31	$4.09	3
Iowa	8,308	$5.32	$4.24	1
Utah	8,000	$5.50	$4.33	2
Indiana	7,503	$5.28	$4.18	2
Nebraska	6,822	$5.50	$4.36	2
Wisconsin	6,452	$5.23	$4.17	1
Nevada	4,800	$5.43	$4.24	1
Mississippi	4,175	$5.33	$4.01	2
New Mexico	3,675	$5.21	$4.25	2

Related codes

J7345Aminolevulinic acid hcl for topical administration$1.66
J7328Hyaluronan or derivative$0.52
J7318Hyaluronan or derivative$6.47
J7325Hyaluronan or derivative$8.81
J7336Capsaicin 8% patch$3.25
J7329Hyaluronan or derivative$7.16
J7322Hyaluronan or derivative$17.14
J7332Hyaluronan or derivative$10.15
J7331Hyaluronan or derivative$10.27
J7321Hyaluronan or derivative$72.31
J7323Hyaluronan or derivative$118.58
J7324Hyaluronan or derivative$123.96

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.