RxDoctor Payments Data

HCPCS J7328

Hyaluronan or derivative, gelsyn-3, for intra-articular injection, 0.1 mg

$0.52Medicare-allowed amount per service, averaged across 7,575,407 services
Providers submitted
$4.63

Asking price, not received

Medicare allowed
$0.52

The fee schedule figure

Medicare paid
$0.40

Balance is patient coinsurance

Providers submitted an average of $4.63 for this code and Medicare allowed $0.528.9× 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 $0.40 (77%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility
$0.52
Hospital / facility
$0.55

The facility rate is higher for this code, which is unusual and generally means the service depends on equipment or staffing a hospital carries. 7,568,015 services were billed in an office setting and 7,392 in a facility.

Services
7,575,407

Medicare Part B, 2024

Beneficiaries
12,061
Providers billing it
444
Total allowed
$3,939,212

Services × allowed amount

What Medicare pays for HCPCS J7328

Across 7,575,407 services billed by 444 providers to 12,061 beneficiaries, Medicare allowed an average of $0.52 per service. That is 628.1 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 J7328

SpecialtyServicesBeneficiariesAvg allowedProviders
Orthopedic Surgery3,465,2745,595$0.52191
Physician Assistant1,992,4013,353$0.52116
Nurse Practitioner521,050886$0.5235
Family Practice401,399517$0.5221
Sports Medicine375,879529$0.5221
Physical Medicine and Rehabilitation371,975512$0.5125
Rheumatology198,187259$0.5113
Anesthesiology94,783156$0.518
Pain Management78,460105$0.527
Internal Medicine16,96828$0.521
Interventional Pain Management15,79330$0.532
Pediatric Medicine14,11220$0.531
Neurology12,32623$0.521
Hand Surgery9,40834$0.551
Ambulatory Surgical Center7,39214$0.551

J7328 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
California1,219,473$0.52$0.4167
New York761,685$0.51$0.4137
Illinois701,121$0.52$0.4136
Texas677,789$0.52$0.4038
Florida589,330$0.52$0.4033
North Carolina553,607$0.52$0.4033
Colorado326,891$0.52$0.4019
Arizona287,959$0.51$0.3920
Ohio271,833$0.53$0.4120
Michigan260,404$0.52$0.4118
Georgia206,775$0.52$0.4013
Maryland174,952$0.52$0.4012
Kansas158,763$0.50$0.3813
South Carolina158,256$0.51$0.397
Connecticut140,953$0.53$0.429
Tennessee137,275$0.52$0.416
West Virginia131,441$0.51$0.407
Oklahoma104,081$0.51$0.408
Mississippi89,093$0.54$0.436
Pennsylvania83,506$0.52$0.405
Nevada75,268$0.52$0.414
Nebraska66,997$0.52$0.425
Indiana58,358$0.52$0.403
Arkansas55,272$0.52$0.411
Oregon51,576$0.52$0.402
New Jersey47,403$0.53$0.424
New Mexico36,288$0.52$0.402
Missouri26,058$0.52$0.401
Minnesota24,874$0.51$0.392
Massachusetts22,178$0.51$0.403
Rhode Island20,130$0.52$0.423
Alabama18,480$0.52$0.411
Kentucky11,256$0.52$0.411
Louisiana8,400$0.53$0.431
Virginia8,274$0.53$0.422
Alaska5,544$0.56$0.441
North Dakota3,864$0.52$0.401

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.