J7326
J7326 – Hyaluronan or derivative, gel-one, for intra-articular injection, per do · NDC Crosswalk & Billing Units
HCPCS Level II J-code · Medicare Part B drug billing
J-code
● 1 NDC crosswalked per per dose $533.592/unit ASP+6%
📋 J7326 summary
J7326 is a HCPCS Level II J-code used to bill Hyaluronan or derivative, gel-one, for intra-articular injection, per dose, billed per per dose. The number of billing units to report depends on the dose administered and the NDC/package billed — use the calculator below.
Brand names associated with J7326: Gel-One
Code J7326
Billing unit per dose Payment limit $533.592/unit NDC-Crosswalk 1
Quarter Q3 2026
RxCUI Atlas Trace the drug concept →
⚠ An NDC↔HCPCS crosswalk and a published payment limit do not guarantee payer coverage or payment. Always verify the current payer policy and claim format before billing.
🗂️ Key billing facts
HCPCS codeJ7326
DescriptorHyaluronan or derivative, gel-one, for intra-articular injection, per dose
Billing unitper dose
Payment limit / unit$533.592
Est. ASP / unit$503.389 est.
Mapped NDCs1
Data periodQ3 2026
Last updated2026-08-20
🧾 Billing & reimbursement HCPCS · CMS · EFF. Q3 2026
📅 Payment limits effective Q3 2026 — from the CMS Medicare Part B Payment Limit File (revised quarterly).
Medicare payment limit / unit
$533.592
Est. ASP / unit
$503.389 est.
Est. after 2% sequester
$522.920
HCPCS dosage
per dose
The CMS payment limit is the Medicare Part B drug allowance (ASP + 6%, statutory). After the 2% federal sequester the effective payment is ≈ ASP + 4.3%; estimated ASP = payment limit ÷ 1.06. Source: CMS Medicare Part B Payment Limit File (quarterly), Q3 2026.
Full HCPCS code details (official CMS record)
Long descriptionHyaluronan or derivative, gel-one, for intra-articular injection, per dose
CoverageC — Carrier/MAC judgment
Pricing indicator51 — Drug — priced under the ASP methodology
Type of service1 — Medical care
BETOS-2O1E
ASC payment groupYY
Action codeN — No maintenance this year
Effective date2017-01-01
Date added2012-01-01
Source: CMS HCPCS Level II code file (imported via admin).
🧮 Dosing & billing-units calculator HCPCS UNITS
One billing unit of J7326 = 1 unit. Enter a regimen to convert dose → billing units and project a full course.
Billing units = dose ÷ HCPCS unit size. Most payers require whole units — round per the payer's policy. “Est. Medicare pay” uses the current payment limit. For single-dose vials, drug discarded after administration may be separately billable with modifier JW (JZ when none is discarded) where allowed. Always verify payer-specific rounding before billing.
🔁 NDCs that bill under J7326 WITH EST. MEDICARE PAY
1 NDC map to J7326. Bill units = how many HCPCS units one package represents. Est. pay / pkg = payment limit ($533.592/unit) × that package's bill units.
| NDC (11-digit) | Drug | Labeler | Package | Strength | Bill units | Est. pay / pkg | NADAC / unit | Status | Source |
|---|---|---|---|---|---|---|---|---|---|
| 50016-0957-11 | Gel-One | Zimmer | — | — | 1 | $533.59 | — | — | CMS ASP |
NDC→HCPCS mappings come from the CMS ASP NDC-HCPCS crosswalk; additional DME MAC / DMEPOS mappings come from PDAC and are labeled separately. NADAC from CMS (weekly). “Status” reflects the product's marketing / obsolete flag in the NDC directory. Presence or absence here does not determine Medicare coverage. Linked NDCs open the full product page.
📊 Medicare utilization & spend CMS · PART B · 2026 (Q1)
Period
Total Part B spend
$11.18M
Claims
16,189
Beneficiaries
15,990
Spend / beneficiary
$698.96
Spend / claim
$690.37
Trend by period
Where J7326 ranks among Part B drugs · 2026 (Q1) · neighbors ±5
Total spending — #172 of 824
#167
RUXIENCE Q5119
$11.73M
#168
SPIKEVAX * 91322
$11.59M
#169
OGIVRI Q5114
$11.51M
#170
GAMMAGARD S-D J1566
$11.36M
#171
TREMFYA ONE-PRESS* J1628
$11.31M
#172
GEL-ONE J7326
$11.18M
#173
ILARIS J0638
$11.05M
#174
HYMOVIS ONE* J7322
$10.91M
#175
BIVIGAM J1556
$10.79M
#176
OCREVUS ZUNOVO J2351
$10.44M
#177
DUROLANE J7318
$10.44M
Total claims — #129 of 824
#124
NULOJIX J0485
17,290
#125
AMELUZ J7345
16,994
#126
ADACEL TDAP* 90715
16,971
#127
PADCEV J9177
16,557
#128
GELSYN-3 J7328
16,416
#129
GEL-ONE J7326
16,189
#130
KYPROLIS J9047
15,969
#131
BORTEZOMIB(J9041)* J9041
15,380
#132
IRON SUCROSE* J1756
15,220
#133
REBLOZYL J0896
15,092
#134
OMNIPAQUE Q9965
15,067
Top Medicare Part B drugs by the selected metric. Click any drug to open its J-code page. Source: CMS Medicare Quarterly Part B Spending by Drug.
Full breakdown by period (2)
| Period | Total spend | Beneficiaries | Claims | $/beneficiary | $/claim |
|---|---|---|---|---|---|
| 2026 (Q1) | $11.18M | 15,990 | 16,189 | $698.96 | $690.37 |
| 2025 (Q1-Q4) | $52.19M | 62,027 | 75,064 | $841.34 | $695.22 |
Provider-administered (Part B) spend, calculated for the whole HCPCS code (CMS does not publish Medicare spend per individual NDC). Self-administered use is covered under Part D instead. A blank patient count means fewer than 11 people — CMS hides counts that small to protect privacy. Source: CMS Medicare Quarterly Part B Spending by Drug (data.cms.gov), updated quarterly.
📈 Medicare Part B claims detail CMS PSPS · 2024
Calendar-year 2024 Medicare Part B fee-for-service activity for this HCPCS code, summed across all carriers, localities and specialties (CMS Physician/Supplier Procedure Summary). A “service” is one billed line/unit — not one claim — so counts run higher than claim counts.
Allowed charges
$47.14M
Medicare paid
$37.49M
Submitted services
94,433
Denial rate
4.3%
Allowed / service
$521.54
Submitted charges
$151.43M
Source: CMS Physician/Supplier Procedure Summary (PSPS), CY2024 — Medicare Part B carrier + DME fee-for-service claims (excludes Medicare Advantage). Figures are for the whole HCPCS code, which may cover uses beyond this drug. ⚠ CMS hides any figure covering fewer than 11 patients (a privacy rule), so totals — especially denials and low-volume codes — run a little low.
🗺️ Where J7326 is utilized CMS · BY PROVIDER · 2024
Medicare Part B services for this code by the rendering provider's state — 82,209 services across 47 states & territories in 2024 (CMS reports include DC and U.S. territories). Switch to per 100k to compare states fairly regardless of population. Hover or tap a state for its top ZIP codes.
Hover or tap a state to see its numbers + top ZIP codes.
Per-capita = services ÷ 2023 state population × 100,000 (so high-population states aren't automatically "hotter"). Counts reflect the provider's location, not the patient's. Providers with fewer than 11 patients are hidden by CMS for privacy, so totals run low and per-100k can be noisy in small states — read this as relative geography, not exact counts. Source: CMS Medicare Physician & Other Practitioners — by Provider and Service, 2024.
🗃️ Data sources & freshness
Every figure on this page is computed from public datasets. Here's what each section draws on and how current it is.
HCPCS code & descriptor
CMS HCPCS Level II code file
Loaded
Payment limit & billing unit
CMS Medicare Part B ASP Pricing File (quarterly)
Q3 2026 · as of 2026-08-20
NDC ↔ HCPCS crosswalk
CMS ASP NDC-HCPCS crosswalk
1 NDC mapped
NADAC acquisition cost
CMS National Average Drug Acquisition Cost (weekly)
Not available for mapped NDCs
Utilization & spend
CMS Part B Spending by Drug · PSPS · Physician & Other Practitioners
Latest data year 2026
Figures are estimates for reference and may lag the source files. Always verify against the current CMS files and your payer's policy before submitting claims.
⚠️ Practical billing caveats
- A crosswalk is not coverage. An NDC mapping or a published payment limit does not guarantee a payer will cover or pay this code. Check the specific plan's policy.
- Units ≠ milligrams. Bill the number of HCPCS units (dose ÷ the code's unit size), not the milligram dose. Use the calculator above.
- Discarded drug. For single-dose vials, drug discarded after administration may be separately billable with modifier JW (and JZ when nothing is discarded) where the payer allows.
- Rounding & partial units. Many payers require whole units; round per the payer's policy, not automatically up.
- The code can cover more than this drug. Some HCPCS codes span multiple products or strengths — confirm the exact code for the product administered.
- Figures lag. ASP limits change quarterly and utilization data are released with a delay. Verify against the current CMS files before billing.
❓ J7326 billing FAQ
What is HCPCS code J7326?
J7326 is a HCPCS Level II J-code used to bill Hyaluronan or derivative, gel-one, for intra-articular injection, per dose under Medicare Part B and most medical (not pharmacy) benefits.
What is the billing unit for J7326?
One unit of J7326 represents per dose. Report the number of units equal to the dose administered divided by per dose.
How many units of J7326 should I bill?
Divide the dose administered by the code's unit size (per dose) to get the number of billing units, then round per your payer's policy. The calculator on this page converts a dose into billing units and projects a full course.
How much does Medicare pay for J7326?
The Medicare Part B payment limit is $533.592 per unit (Q3 2026), based on ASP + 6%. After the 2% sequester the effective payment is about $522.920 per unit. Payment limits are revised quarterly.
Which NDCs bill under J7326?
1 NDC currently map to J7326 in the CMS ASP NDC-HCPCS crosswalk. See the NDC crosswalk table above for each product, package, billing units and estimated reimbursement.
Does a crosswalk mean J7326 is covered?
No. An NDC-to-HCPCS crosswalk and a published payment limit do not guarantee coverage or payment. Coverage depends on the payer, the diagnosis and the site of care — always verify the current policy before billing.
For professional billing reference only — verify against the current CMS files before submitting claims.