Hyalgan supartz visco-3 dose
Products billed under this code include Hyalgan, Supartz FX, Visco-3.
Payment limit per per dose, by effective quarter, 1Q21 to 4Q26. Gaps mean the code was not in that quarter’s file, or CMS gave no payment limit.Products billed under this code include Hyalgan, Supartz FX, Visco-3.
Payment limit per per dose, by effective quarter, 1Q21 to 4Q26. Gaps mean the code was not in that quarter’s file, or CMS gave no payment limit.From the 4Q26 NDC–HCPCS crosswalk. “Limit / pkg” is the 4Q26 payment limit times the billing units in one package.
| Product | Labeler | NDC | Units / pkg | Limit / pkg |
|---|---|---|---|---|
| Hyalgan | Fidia Pharma USA Inc | 89122-0724-12 | 1 | $69.868 |
| Hyalgan | Fidia Pharma USA Inc | 89122-0724-20 | 1 | $69.868 |
| Supartz FX | Bioventus LLC | 89130-4444-01 | 1 | $69.868 |
| Visco-3 | Zimmer Biomet | 50016-0957-21 | 3 | $209.604 |
| Quarter | Payment limit | Change | Billing unit | Description | Source file |
|---|---|---|---|---|---|
| 4Q26 | $69.868 | −$0.414 | per dose | Hyalgan supartz visco-3 dose | v1, posted September 17, 2026 |
| 3Q26 | $70.282 | −$4.152 | per dose | Hyalgan supartz visco-3 dose | v1, posted September 15, 2026 |
| 2Q26 | $74.434 | +$1.469 | per dose | Hyalgan supartz visco-3 dose | v1, posted September 15, 2026 |
| 1Q26 | $72.965 | +$1.442 | per dose | Hyalgan supartz visco-3 dose | v1, posted September 15, 2026 |
| 4Q25 | $71.523 | −$1.864 | per dose | Hyalgan supartz visco-3 dose | v1, posted September 8, 2026 |
| 3Q25 | $73.387 | −$0.573 | per dose | Hyalgan supartz visco-3 dose | v1, posted March 10, 2026 |
| 2Q25 | $73.96 | +$0.934 | per dose | Hyalgan supartz visco-3 dose | v1, posted March 10, 2026 |
| 1Q25 | $73.026 | −$0.196 | per dose | Hyalgan supartz visco-3 dose | v1, posted December 19, 2025 |
| 4Q24 | $73.222 | −$2.262 | per dose | Hyalgan supartz visco-3 dose | v1, posted June 11, 2025 |
| 3Q24 | $75.484 | +$2.366 | per dose | Hyalgan supartz visco-3 dose | v1, posted June 11, 2025 |
| 2Q24 | $73.118 | +$0.023 | per dose | Hyalgan supartz visco-3 dose | v1, posted March 11, 2025 |
| 1Q24 | $73.095 | −$2.671 | per dose | Hyalgan supartz visco-3 dose | v1, posted December 19, 2024 |
| 4Q23 | $75.766 | +$2.286 | per dose | Hyalgan supartz visco-3 dose | v1, posted October 10, 2024 |
| 3Q23 | $73.48 | +$0.967 | per dose | Hyalgan supartz visco-3 dose | v1, posted June 5, 2024 |
| 2Q23 | $72.513 | −$6.17 | per dose | Hyalgan supartz visco-3 dose | v1, posted February 23, 2024 |
| 1Q23 | $78.683 | +$1.725 | per dose | Hyalgan supartz visco-3 dose | v1, posted December 6, 2023 |
| 4Q22 | $76.958 | +$0.869 | per dose | Hyalgan supartz visco-3 dose | v1, posted June 22, 2023 |
| 3Q22 | $76.089 | +$1.179 | per dose | Hyalgan supartz visco-3 dose | v1, posted June 9, 2023 |
| 2Q22 | $74.91 | −$1.029 | per dose | Hyalgan supartz visco-3 dose | v1, posted December 14, 2022 |
| 1Q22 | $75.939 | −$1.304 | per dose | Hyalgan supartz visco-3 dose | v1, posted June 8, 2022 |
| 4Q21 | $77.243 | +$4.199 | per dose | Hyalgan or supartz inj dose | v1, posted June 2, 2022 |
| 3Q21 | $73.044 | −$2.979 | per dose | Hyalgan or supartz inj dose | v1, posted June 2, 2022 |
| 2Q21 | $76.023 | +$0.853 | per dose | Hyalgan or supartz inj dose | v1, posted March 1, 2022 |
| 1Q21 | $75.17 | – | per dose | Hyalgan or supartz inj dose | v1, posted December 10, 2021 |
“Change” is the difference from the previous quarter, shown only when both quarters have a payment limit and the billing unit is the same. “vs. last quarter” and “vs. a year ago” follow the same rule.