Hyaluronan, hymo or hymo one
Products billed under this code include Hymovis, Hymovis One.
Payment limit per 1 MG, by effective quarter, 3Q22 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 Hymovis, Hymovis One.
Payment limit per 1 MG, by effective quarter, 3Q22 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 |
|---|---|---|---|---|
| Hymovis | Fidia Pharma USA Inc | 89122-0496-01 | 24 | $430.56 |
| Hymovis | Fidia Pharma USA Inc | 89122-0496-63 | 48 | $861.12 |
| Hymovis One | Fidia Pharma USA Inc | 89122-0750-01 | 32 | $574.08 |
| Quarter | Payment limit | Change | Billing unit | Description | Source file |
|---|---|---|---|---|---|
| 4Q26 | $17.94 | −$0.191 | 1 MG | Hyaluronan, hymo or hymo one | v1, posted September 17, 2026 |
| 3Q26 | $18.131 | −$0.003 | 1 MG | Hymovis injection 1 mg | v1, posted September 15, 2026 |
| 2Q26 | $18.134 | +$0.494 | 1 MG | Hymovis injection 1 mg | v1, posted September 15, 2026 |
| 1Q26 | $17.64 | +$0.022 | 1 MG | Hymovis injection 1 mg | v1, posted September 15, 2026 |
| 4Q25 | $17.618 | +$0.178 | 1 MG | Hymovis injection 1 mg | v1, posted September 8, 2026 |
| 3Q25 | $17.44 | −$0.063 | 1 MG | Hymovis injection 1 mg | v1, posted March 10, 2026 |
| 2Q25 | $17.503 | +$0.088 | 1 MG | Hymovis injection 1 mg | v1, posted March 10, 2026 |
| 1Q25 | $17.415 | −$0.033 | 1 MG | Hymovis injection 1 mg | v1, posted December 19, 2025 |
| 4Q24 | $17.448 | −$0.111 | 1 MG | Hymovis injection 1 mg | v1, posted June 11, 2025 |
| 3Q24 | $17.559 | +$0.05 | 1 MG | Hymovis injection 1 mg | v1, posted June 11, 2025 |
| 2Q24 | $17.509 | +$0.245 | 1 MG | Hymovis injection 1 mg | v1, posted March 11, 2025 |
| 1Q24 | $17.264 | −$0.031 | 1 MG | Hymovis injection 1 mg | v1, posted December 19, 2024 |
| 4Q23 | $17.295 | +$0.276 | 1 MG | Hymovis injection 1 mg | v1, posted October 10, 2024 |
| 3Q23 | $17.019 | +$0.357 | 1 MG | Hymovis injection 1 mg | v1, posted June 5, 2024 |
| 2Q23 | $16.662 | +$0.013 | 1 MG | Hymovis injection 1 mg | v1, posted February 23, 2024 |
| 1Q23 | $16.649 | −$0.185 | 1 MG | Hymovis injection 1 mg | v1, posted December 6, 2023 |
| 4Q22 | $16.834 | +$1.126 | 1 MG | Hymovis injection 1 mg | v1, posted June 22, 2023 |
| 3Q22 | $15.708 | – | 1 MG | Hymovis injection 1 mg | v1, posted June 9, 2023 |
“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.