HCPCS code for one injection of Orthovisc, a hyaluronan knee injection given as a short weekly series for knee osteoarthritis.
- Medicare
- $0.00
- Work RVU
- 0
- Global, days
- Region
- Knee
Documentation requirements
What must appear in the operative or office note to support the claim.
Source · Editorial brief grounded in 3 cited references ↓
- Radiographic knee osteoarthritis
- Conservative therapy tried and failed
- Product name, NDC, and injection number
- Laterality on each procedure line
- Interval and response for repeat series
Applicable modifiers
Modifiers commonly billed with this code.
Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual
What this code covers
Source · Editorial summary grounded in 3 cited references ↓
J7324 covers one dose of Orthovisc. The series is usually three or four weekly knee injections, one unit per visit. Monovisc, the single-injection product from the same manufacturer, has its own code (J7327), so do not bill Monovisc as J7324.
The injection procedure is 20610 or 20611 with RT or LT. If both knees are injected, bill two drug units. Medicare takes the procedure once with modifier 50, while some commercial plans want separate RT and LT lines. An E/M at series visits needs a separate, documented problem and modifier 25, otherwise it will likely deny or get recouped on audit.
Coverage depends on the same story every hyaluronan claim needs: radiographic knee OA, failed NSAIDs or analgesics, an exercise or PT trial, and in most cases a prior steroid injection. For repeat courses, payers want six months since the last series and documented improvement. Orthovisc comes in single-dose syringes, so use JZ when the full syringe is given.
RVU & reimbursement
Component RVUs and Medicare national rate. Actual payment varies by GPCI locality.
Source · CMS Physician Fee Schedule, RVU26A · January 2026
| Work RVU | 0 |
| Practice expense RVU | 0 |
| Malpractice RVU | 0 |
| Total RVU | 0 |
| Medicare national rate | $0.00 |
| Global period | days |
Payment by site of service
Medicare pays different rates by setting. HOPD typically pays substantially more than ASC for the same procedure.
Source · CMS OPPS Addendum B·ASC HCPCS payment rates·2026
| Setting | Medicare rate (national) |
|---|---|
Office (PFS non-facility) Procedure performed in physician's office | $0.00 |
HOPD (APC 0877) Hospital outpatient department | $111.26 |
Common denial reasons
The recurring reasons claims for CPT J7324 get rejected.
Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓
- Monovisc billed under J7324
- Payer prefers a different hyaluronan product
- Repeat series within six months
- Missing JZ modifier
- Conservative care not documented
Frequently asked questions
Source · Generated from the editorial pipeline, verified against 3 cited references ↓
01Is Monovisc billed with J7324?
02How many units of J7324 per visit?
03What does a payer need to cover Orthovisc?
Sources & references
Editorial content was developed using the following public sources.
- 01CMS Physician Fee Schedule 2026
- 02CMS Medicare Part B Drug Average Sales Price files
- 03cms.govhttps://www.cms.gov/medicare/coding-billing/national-correct-coding-initiative-ncci-edits
Mira Scribe
Mira Scribe notes document the knee findings, failed treatments, and series progress at each visit, which keeps Orthovisc claims supported from the first shot to the last.
See how Mira captures CPT J7324 documentation