HCPCS code for one injection of Euflexxa, a hyaluronan knee injection usually given once a week for three weeks.
- 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
- Failed conservative care documented with dates
- Injection number in the series and laterality
- NDC and lot number
- Response to prior series before repeating
- Procedure note supporting 20610 or 20611
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 ↓
J7323 covers one dose of Euflexxa. The usual course is three weekly injections into the knee, one unit of J7323 at each visit. The injection itself is billed with 20610 or 20611 (if ultrasound guidance is used and documented), plus RT or LT.
Euflexxa is a common choice because some commercial plans list it as a preferred hyaluronan. Check the patient's formulary before starting a series. Switching products mid-series is a denial magnet, and starting with a non-preferred product can deny the whole course.
What payers look for: radiographic knee OA, symptoms not controlled by NSAIDs or analgesics, a trial of exercise or PT, and usually at least one steroid injection. Repeat series need about six months between courses and evidence the last series helped. Avoid billing an E/M at the second and third visits unless there is a separate problem to address. Euflexxa comes in single-dose syringes, so use JZ when nothing is wasted.
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 0875) Hospital outpatient department | $105.46 |
Common denial reasons
The recurring reasons claims for CPT J7323 get rejected.
Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓
- Euflexxa not on the payer's preferred list
- Repeat course within six months
- Missing conservative therapy history
- Missing JZ modifier
- E/M billed at routine series visits
- Ultrasound guidance billed without a saved image or documentation
Frequently asked questions
Source · Generated from the editorial pipeline, verified against 3 cited references ↓
01How many units of J7323 for a Euflexxa series?
02What CPT code is billed with Euflexxa?
03Can I bill an office visit with every Euflexxa injection?
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 record the knee exam, imaging findings, and prior treatments at the start of the series, so each injection visit stands on a documented medical necessity trail.
See how Mira captures CPT J7323 documentation