#3274 of 11K

J7325

Synvisc or synvisc-one injection for joint supplementation

Synvisc or synvisc-one injection for joint supplementation is the #3,274 most-billed Medicaid procedure code, with $2.1M in payments across 20K claims from 2018–2024. The national median cost per claim is $85.94. Costs vary widely — the 90th percentile is $565.09 per claim, 6.6× the median.

Total Paid

$2.1M

0.00% of all spending

Total Claims

20K

Providers

Avg Cost/Claim

$100

National Cost Distribution

How much do providers bill per claim for J7325? Based on 43 providers billing this code nationally.

Median

$85.94

Average

$216.29

Std Dev

$320.93

Max

$1,660.71

Percentile Distribution (Cost per Claim)

p10

$24.86

p25

$30.72

Median

$85.94

p75

$269.12

p90

$565.09

p95

$695.51

p99

$1,391.85

50% of providers bill between $30.72 and $269.12 per claim for this code.

90% bill between $24.86 and $565.09.

Top 1% bill above $1,391.85.

About This Procedure

HCPCS code J7325 (Synvisc or synvisc-one injection for joint supplementation) was billed by 49 providers across 20K claims, totaling $2.1M in Medicaid payments from 2018–2024. This code was used for 11K unique beneficiaries.

Fraud Risk Context

Injectable drug codes carry high per-claim costs and have been involved in drug diversion and upcoding schemes.

Source: HHS OIG Reports

Risk Assessment

Billing Statistics

Median Cost/Claim

$85.94

Providers Billing

National Spending

$2.1M

Avg/Median Ratio

2.52×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for J7325

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1255644357	$603K	$1,020.57	11.9× median	Top 10%
2	1740236728	$504K	$94.13	1.1× median	Above Median
3	1871531426	$235K	$85.94	1.0× median	Below Median
4	1164474250	$132K	$517.53	6.0× median	Above 75th
5	1114239332	$131K	$517.39	6.0× median	Above 75th
6	Maricopa County Special Health Care District Phoenix, AZ · General Acute Care Hospital	$68K	$1,660.71	19.3× median	Top 1%
7	1235168964	$68K	$27.94	0.3× median	Below Median
8	1609985506	$58K	$46.54	0.5× median	Below Median
9	Accredo Health Group Inc Memphis, TN · Pharmacy	$32K	$315.05	3.7× median	Above 75th
10	1144497678	$28K	$110.59	1.3× median	Above Median
11	1750333936	$24K	$47.94	0.6× median	Below Median
12	1073827101	$16K	$267.63	3.1× median	Above Median
13	1417961137	$12K	$606.53	7.1× median	Top 10%
14	1184824146	$12K	$5.90	0.1× median	Below Median
15	University Of Colorado Hospital Authority Aurora, CO · General Acute Care Hospital	$11K	$270.60	3.1× median	Above 75th
16	1073606901	$10K	$88.73	1.0× median	Above Median
17	1992905533	$9K	$29.26	0.3× median	Below Median
18	1306899463	$8K	$705.40	8.2× median	Top 10%
19	1760624423	$8K	$30.80	0.4× median	Below Median
20	1265629133	$8K	$161.41	1.9× median	Above Median

Showing top 20 of 49 providers billing this code

Related Procedures

J7323$7.0M J7321Hyaluronan injection for knee joint supplement$3.4M J7324$2.9M J7320$2.7M J7318$1.7M

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