The J code for Euflexxa is J7323, covering hyaluronan or its derivative for intra-articular injection per dose.
How do you code Euflexxa?
Euflexxa is coded with HCPCS code J7323 for intra-articular injection per dose.
Use J7323 on claims when giving Euflexxa for knee osteoarthritis. Pair it with CPT code 20610 for the knee injection procedure. Always double-check payer rules—some may want extra modifiers or notes.
What is the CPT code for Euflexxa injection?
The CPT code for an Euflexxa injection is J7323, under HCPCS for hyaluronan derivatives.
J7323 is a supply code, not a standalone procedure code. Add the injection separately using CPT 20610 or 20611 if ultrasound guidance was used, per CMS HCPCS guidelines.
What is CPT J7323?
J7323 is a HCPCS code for hyaluronan or derivative, Euflexxa, for intra-articular injection per dose.
This code covers the hyaluronic acid product itself, not the injection service. Mostly used for knee osteoarthritis, it must be billed with a procedure code like 20610 (injection without ultrasound) or 20611 (injection with ultrasound guidance).
What is CPT code J7325?
J7325 is a HCPCS code for Synvisc or Synvisc One (hyaluronan derivative) for intra-articular injection, 1 mg.
Unlike Euflexxa (J7323), J7325 is dosed per milligram. Synvisc One is usually given as a single 48 mg injection, billed as 48 units of J7325. Check payer policies—some need prior authorization.
What is EUFLEXXA used for?
EUFLEXXA is used to relieve knee pain from osteoarthritis, especially in patients who don’t get enough relief from acetaminophen, physical therapy, or exercise.
It’s an intra-articular injection of 1% sodium hyaluronate meant to supplement synovial fluid. Studies show it may cut pain for up to 6 months per cycle. Always talk to an orthopedic specialist before starting.
What is the strength of EUFLEXXA?
EUFLEXXA has a strength of 10 mg/mL sodium hyaluronate (molecular weight 2.4–3.6 million daltons).
| Brand | Strength | Dose Form |
|---|
| EUFLEXXA | 10 mg/mL | 2 mL vial (20 mg dose) |
| Hyalgan | 10 mg/mL | 2 mL vial |
| Gelsyn-3 | 16.8 mg/2 mL | Pre-filled syringe |
| ORTHOVISC | 30 mg/2 mL | Pre-filled syringe |
How much do Euflexxa injections cost?
Euflexxa injections typically cost $900 to $1,400 per dose without insurance, based on 2026 retail pricing.
With Medicare or private insurance, out-of-pocket costs vary. Medicare covers J7323 if clinical criteria are met; patients may pay a copay or coinsurance. Use GoodRx or manufacturer coupons to bring costs down to around $500–$800 per injection, as of 2026.
What does CPT code 20610 mean?
CPT code 20610 represents arthrocentesis, aspiration, and/or injection of a major joint or bursa (e.g., knee, shoulder, hip) without ultrasound guidance.
This code includes fluid removal and injection when done. Use it for Euflexxa unless ultrasound guidance is used—then 20611 applies. Always document the procedure in the medical record.
What is procedure code 20611?
CPT code 20611 is for arthrocentesis, aspiration and/or injection of a major joint or bursa with ultrasound guidance and permanent recording.
This code is more detailed and reimbursed higher than 20610. Required elements include image storage and reporting. Use 20611 when precise needle placement matters, such as in obese patients or small joints.
Does Medicare pay for J7323?
Yes, Medicare pays for J7323 when medically necessary, such as for knee osteoarthritis with radiographic evidence of joint damage.
Coverage includes the drug and the injection procedure (20610 or 20611). Patients usually have no cost-sharing for the injection if they meet criteria, but deductibles or coinsurance may apply. Confirm prior authorization requirements with the payer.
What is J7321?
J7321 is a HCPCS code for Hyalgan or Supartz (hyaluronan derivatives) for intra-articular injection per dose.
This code applies to older hyaluronic acid products. Like J7323, it’s billed with a procedure code (e.g., 20610). Newer products like Euflexxa have taken over in many practices.
Is Euflexxa covered by Medicare?
Yes, Euflexxa is covered by Medicare for qualifying patients with knee osteoarthritis.
Coverage applies to both the drug (J7323) and the injection (20610/20611). Most private insurers also cover it, though copays or prior authorization may be required. Check your specific plan details with the insurer or provider.
How do I bill CPT code J7324?
Bill one unit of J7324 per 30 mg dose administered.
J7324 is used for products like ORTHOVISC. If a patient gets a 30 mg dose in one knee, report one unit. For both knees, bill two units. Always pair with a procedure code and add laterality modifiers (e.g., -RT, -LT).
What is the ICD 10 code for M17 11?
M17.11 is the ICD-10-CM code for unilateral primary osteoarthritis, right knee.
Related codes include M17.12 (left knee) and M17.0 (bilateral). Make sure the diagnosis matches the treated joint and is backed by imaging and clinical findings. Accurate coding supports medical necessity for injection therapy.
How do you code a Synvisc injection?
Code Synvisc or Synvisc One using J7325 for the drug and 20610 or 20611 for the injection.
Synvisc usually needs three weekly injections; Synvisc One is a single 48 mg injection. Report 48 units of J7325 for Synvisc One. Verify payer policies—some require step therapy with cheaper options first.
