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See a sample rate comparisonHCPCS J7318 (Durolane) Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Hyaluronan or derivative, durolane, for intra-articular injection, 1 mg
| Key Fact | Detail |
|---|---|
| Service Type | Drugs Administered Other than Oral Method Miscellaneous Drugs |
| Common Place of Service | 11 - Office None |
| Complexity Level | Low |
| Medicaid Fee Schedule | View Medicaid rates for J7318 |
| Medicare Payment Limit | $6.773  |
| WAC Price | Lorem ipsum dolor sit amet consectetur Lorem ipsum dolor sit amet consectetur VisitBuyandBill.com |
National average reimbursement for HCPCS J7318 by major payers:
$9.02
$7.78
$8.82
$7.72
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HCPCS J7318
5 of 25 sample ratesHigher to lower in this preview
University Hospitals Ahuja Medical Center, Inc, Uh Ahuja Medical Center
$9.22Published rateLincoln Medical And Mental Health Center
New York City Health And Hospitals Corporation
$7.42Published rateJackson County Memorial Hospital Authority, Jackson Co Mem Hosp
$7.00Published rateSt. Joseph'S Hospital, Inc., St. Joseph'S Hospital
St Josephs Hospital Inc
$6.69Published rateMakini Chisolm-Straker
New York City Health And Hospitals Corporation
$4.63Published rate
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See a sample payer proposalHCPCS J7318 vs. Other Miscellaneous Drugs Codes
The HCPCS J7318 code is part of the Drugs Administered Other than Oral Method services used for Miscellaneous Drugs. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The HCPCS J7318 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| J7316-HCPCS | Moderate | Injection, ocriplasmin, 0.125 mg |
| J7318-HCPCS | Low | Hyaluronan or derivative, durolane, for intra-articular injection, 1 mg |
| J7320-HCPCS | Low | Hyaluronan or derivitive, genvisc 850, for intra-articular injection, 1 mg |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS J7318. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the J7318 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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