How much does Medicare pay for HCPCS J7321?

Medicare allowed an average of $72.31 per service and paid $56.58 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $251.65, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is HCPCS code J7321?

Hyaluronan or derivative, hyalgan, supartz or visco-3, for intra-articular injection, per dose. It was billed 257,446 times to 49,918 Medicare beneficiaries by 1,483 providers in 2024.

Does J7321 pay differently in an office than a hospital?

Yes. The allowed amount averaged $72.33 in an office setting and $0.08 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 J7321 most?

Orthopedic Surgery, with 82,379 services from 526 clinicians. Next are Physician Assistant, Nurse Practitioner, Physical Medicine and Rehabilitation.

HCPCS J7321

Hyaluronan or derivative, hyalgan, supartz or visco-3, for intra-articular injection, per dose

$72.31Medicare-allowed amount per service, averaged across 257,446 services

Providers submitted

$251.65

Asking price, not received

Medicare allowed

$72.31

The fee schedule figure

Medicare paid

$56.58

Balance is patient coinsurance

Providers submitted an average of $251.65 for this code and Medicare allowed $72.31 — 3.5× 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 $56.58 (78%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $72.33
Hospital / facility: $0.08

The office rate is higher because the practice supplies the room, staff and equipment out of that payment. In a hospital the facility bills those separately, so the clinician's share is smaller — the total cost to Medicare is usually higher, not lower. 257,398 services were billed in an office setting and 48 in a facility.

Services: 257,446
Beneficiaries: 49,918
Providers billing it: 1,483
Total allowed: $18,615,920

What Medicare pays for HCPCS J7321

Across 257,446 services billed by 1,483 providers to 49,918 beneficiaries, Medicare allowed an average of $72.31 per service. That is 5.2 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 J7321

Specialty	Services	Beneficiaries	Avg allowed	Providers
Orthopedic Surgery	82,379	17,745	$72.33	526
Physician Assistant	35,042	8,434	$72.47	281
Nurse Practitioner	27,700	5,207	$72.28	171
Physical Medicine and Rehabilitation	23,427	3,864	$72.32	94
Family Practice	17,880	2,822	$72.46	63
Internal Medicine	12,783	1,805	$72.39	43
Sports Medicine	12,469	2,221	$71.89	56
Rheumatology	11,794	1,889	$72.43	65
Anesthesiology	6,598	1,274	$72.49	39
Interventional Pain Management	5,047	963	$72.52	39
Pain Management	4,471	970	$72.32	49
General Surgery	3,753	419	$69.28	5
Obstetrics & Gynecology	2,961	379	$72.49	2
Osteopathic Manipulative Medicine	2,219	386	$72.45	10
Allergy/ Immunology	2,033	186	$72.55	1

J7321 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
California	56,740	$72.42	$56.94	261
New York	28,705	$71.75	$56.58	126
Florida	27,106	$72.47	$56.29	191
Illinois	23,439	$72.40	$57.18	82
Texas	14,470	$72.20	$56.66	93
Georgia	10,162	$72.56	$56.67	74
Michigan	9,850	$72.12	$56.70	73
Virginia	9,449	$72.44	$56.90	47
South Carolina	9,306	$72.47	$56.31	46
New Jersey	7,139	$72.09	$56.80	50
Arizona	6,722	$72.14	$55.96	37
Tennessee	5,407	$72.40	$56.44	43
Indiana	5,310	$72.31	$56.51	33
Maryland	4,251	$72.64	$56.33	26
North Carolina	4,024	$72.12	$56.75	31
Missouri	3,764	$72.46	$56.76	21
Pennsylvania	3,567	$72.52	$56.70	25
Mississippi	2,413	$71.93	$56.46	13
Colorado	2,396	$72.54	$56.48	19
Wisconsin	2,340	$72.62	$57.04	21
Massachusetts	2,182	$72.41	$56.03	18
Ohio	2,007	$71.96	$56.46	21
Alabama	1,595	$71.90	$56.52	14
Oklahoma	1,565	$72.45	$56.36	9
Nebraska	1,354	$72.43	$57.11	5
Arkansas	1,050	$72.58	$56.79	10
Louisiana	988	$72.51	$56.94	11
Nevada	929	$72.47	$56.62	4
Kansas	909	$72.76	$57.63	6
Montana	844	$72.62	$56.31	5
Wyoming	769	$72.66	$56.51	5
West Virginia	763	$72.72	$56.15	8
Utah	666	$72.50	$57.51	3
Kentucky	664	$71.13	$56.65	7
Hawaii	659	$72.49	$56.41	6
Connecticut	629	$72.70	$57.71	4
Maine	584	$72.53	$56.02	5
Iowa	453	$72.41	$56.37	4
Idaho	452	$72.60	$57.24	3
Washington	374	$72.51	$56.76	4
Minnesota	366	$72.50	$57.51	5
Vermont	323	$73.02	$55.62	6
Guam	267	$71.80	$54.43	3
Oregon	236	$72.70	$56.94	2
New Hampshire	145	$72.94	$58.11	1
New Mexico	113	$72.81	$52.76	2

Related codes

J7345Aminolevulinic acid hcl for topical administration$1.66
J7328Hyaluronan or derivative$0.52
J7318Hyaluronan or derivative$6.47
J7320Hyaluronan or derivitive$5.37
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
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.