Inj, trivisc 1 mg
Products billed under this code include TriVisc.
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 TriVisc.
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 |
|---|---|---|---|---|
| TriVisc | Avanos Medical Sales, LLC | 50653-0006-04 | 25 | $105.175 |
| Quarter | Payment limit | Change | Billing unit | Description | Source file |
|---|---|---|---|---|---|
| 4Q26 | $4.207 | +$1.171 | 1 MG | Inj, trivisc 1 mg | v1, posted September 17, 2026 |
| 3Q26 | $3.036 | −$0.237 | 1 MG | Inj, trivisc 1 mg | v1, posted September 15, 2026 |
| 2Q26 | $3.273 | −$0.333 | 1 MG | Inj, trivisc 1 mg | v1, posted September 15, 2026 |
| 1Q26 | $3.606 | −$1.085 | 1 MG | Inj, trivisc 1 mg | v1, posted September 15, 2026 |
| 4Q25 | $4.691 | −$0.754 | 1 MG | Inj, trivisc 1 mg | v1, posted September 8, 2026 |
| 3Q25 | $5.445 | −$0.141 | 1 MG | Inj, trivisc 1 mg | v1, posted March 10, 2026 |
| 2Q25 | $5.586 | −$0.517 | 1 MG | Inj, trivisc 1 mg | v1, posted March 10, 2026 |
| 1Q25 | $6.103 | −$0.562 | 1 MG | Inj, trivisc 1 mg | v1, posted December 19, 2025 |
| 4Q24 | $6.665 | −$0.425 | 1 MG | Inj, trivisc 1 mg | v1, posted June 11, 2025 |
| 3Q24 | $7.09 | −$0.331 | 1 MG | Inj, trivisc 1 mg | v1, posted June 11, 2025 |
| 2Q24 | $7.421 | −$0.486 | 1 MG | Inj, trivisc 1 mg | v1, posted March 11, 2025 |
| 1Q24 | $7.907 | −$0.657 | 1 MG | Inj, trivisc 1 mg | v1, posted December 19, 2024 |
| 4Q23 | $8.564 | −$0.231 | 1 MG | Inj, trivisc 1 mg | v1, posted October 10, 2024 |
| 3Q23 | $8.795 | −$0.221 | 1 MG | Inj, trivisc 1 mg | v1, posted June 5, 2024 |
| 2Q23 | $9.016 | +$0.061 | 1 MG | Inj, trivisc 1 mg | v1, posted February 23, 2024 |
| 1Q23 | $8.955 | −$0.764 | 1 MG | Inj, trivisc 1 mg | v1, posted December 6, 2023 |
| 4Q22 | $9.719 | +$1.04 | 1 MG | Inj, trivisc 1 mg | v1, posted June 22, 2023 |
| 3Q22 | $8.679 | – | 1 MG | Inj, trivisc 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.