localis

Type a CPT/HCPCS code, a place, a service in plain words, or a whole claim line like 90837 LCSW 94110.

Try

HCPCS J7321 Medicare payment status

Excluded from PFS

J7321 · PFS Q4 2021 · Historical

Status E is not separately payable under the PFS.

View applicable payment rules
View CMS source and method

CMS RVU21DOctober 1 – December 31, 2021

PFS status evidence

Physician relative value file (Q4 2021) · rvu21d.zip (PPRRVU21_OCT.csv row 3,390)
Inspect PFS status evidence
Code
J7321
Release
Q4 2021, revision 1
Result
Excluded from PFS

Citations

  • Shows this code’s PFS status (E). Result: Excluded from PFS.

    Physician relative value file (PPRRVU)CMS RVU21DOctober 1 – December 31, 2021

    This PFS record alone does not establish a $0 allowance or a coverage determination. Any amount from another schedule needs its own evidence.

    PPRRVU21_OCT.csv row 3,390 in rvu21d.zip

    In the CMS file

    Loading rows 3,388–3,392 of PPRRVU21_OCT.csv…

    Download rvu21d.zip from CMS File fingerprint f1972bd23bdc51795ceba7d536bb413a0ba0b47fad8c2ed594e7ee7799877297

Report a problem

HCPCS J7321 has no published national rate. It carries status E (excluded) in the Q4 2021 release. A regulation removes this code from the fee schedule. When covered, it is paid under reasonable charge procedures instead. The blank amount means unpriced, not $0.

Why is there no national PFS amount for J7321?

Its status indicator is E (excluded). A regulation removes this code from the fee schedule. When covered, it is paid under reasonable charge procedures instead. Status E is not separately payable under the PFS.

About this code

Hyalgan supartz visco-3 dose

Which billing rules and modifiers apply? Copy link

CMS's surgical and split-billing indicators don't adjust J7321's amount.

Global surgery period XXX (does not apply).

Why would a Medicare claim for J7321 be denied or paid less?

These come from CMS indicators on this page, not general billing advice.

  • Its status indicator is E (excluded)—A regulation removes this code from the fee schedule. When covered, it is paid under reasonable charge procedures instead. See status indicators

Payer-specific coverage and documentation rules live outside these files, so a claim that clears every check here can still be denied on other grounds.

CMS RVU21DOctober 1 – December 31, 2021

Can you bill it with another code? Copy link

This code

J7321

See every current NCCI pair for J7321 →

Source & method Copy link

  1. 01 PPRRVU21_OCT.csv · Q4 2021 (RVU21D) · row 3,390—status E, RVUs limits
    Effective
    October 1 – December 31, 2021
    Locator
    PPRRVU21_OCT.csv in rvu21d.zip · row 3,390 of 17,432 · via CMS
    Fields read
    Status E (col 4)
    SHA-256 f1972bd23bdc5179…
    Doesn’t establish
    A locality-adjusted allowed amount, or the payment after sequestration. National baselines use GPCI 1.000 and exclude sequestration.
    Note
    Whether a national amount exists depends on the status and CMS’s payment instructions; blank RVUs are never treated as zero.

Cite this rate

HCPCS J7321 National PFS baseline: No national PFS rate (Q4 2021; participating physician; whole service; GPCI 1.000; sequestration excluded). CMS RVU21D, PPRRVU21_OCT.csv row 3,390. Localis. https://localishealth.com/hcpcs/J7321/2021/D

Past releases are never edited, so the citation stays checkable after CMS publishes a newer one. CMS owns the code description shown for HCPCS Level II codes. Methodology · Plain-text summary · JSON

How has it changed? Copy link

— Office (non-facility) and — Facility since Jan 1, 2013.

  1. Jan 1, 2024 – Mar 8, 2024 · Superseded revision

    Q1 2024 rev 1

    Revision 1, later corrected by CMS
    Office
    —
    Facility
    —
  2. Jan 1, 2013 – present

    Q1 2013

    Still in effect · 53 releases at this rate
    Office
    —
    Facility
    —

    Q1 2013 Jan 1, 2013 – Mar 31, 2013 · Q2 2013 Apr 1, 2013 – Jun 30, 2013 · Q2 2014 Apr 1, 2014 – Jun 30, 2014 · Q3 2014 Jul 1, 2014 – Sep 30, 2014 · Q4 2014 Oct 1, 2014 – Dec 31, 2014 · Q1 2015 Jan 1, 2015 – Mar 31, 2015 · Q2 2015 Apr 1, 2015 – Jun 30, 2015 · Q3 2015 Jul 1, 2015 – Sep 30, 2015 · Q4 2015 Oct 1, 2015 – Dec 31, 2015 · Q1 2016 Jan 1, 2016 – Mar 31, 2016 · Q2 2016 Apr 1, 2016 – Jun 30, 2016 · Q3 2016 Jul 1, 2016 – Sep 30, 2016 · Q4 2016 Oct 1, 2016 – Dec 31, 2016 · Q1 2017 Jan 1, 2017 – Mar 31, 2017 · Q2 2017 Apr 1, 2017 – Jun 30, 2017 · Q3 2017 Jul 1, 2017 – Sep 30, 2017 · Q4 2017 Oct 1, 2017 – Dec 31, 2017 · Q1 2018 Jan 1, 2018 – Mar 31, 2018 · Q2 2018 Apr 1, 2018 – Jun 30, 2018 · Q3 2018 Jul 1, 2018 – Sep 30, 2018 · Q4 2018 Oct 1, 2018 – Dec 31, 2018 · Q1 2019 Jan 1, 2019 – Mar 31, 2019 · Q2 2019 Apr 1, 2019 – Jun 30, 2019 · Q3 2019 Jul 1, 2019 – Sep 30, 2019 · Q4 2019 Oct 1, 2019 – Dec 31, 2019 · Q1 2020 Jan 1, 2020 – Mar 31, 2020 · Q2 2020 Apr 1, 2020 – Jun 30, 2020 · Q3 2020 Jul 1, 2020 – Sep 30, 2020 · Q4 2020 Oct 1, 2020 – Dec 31, 2020 · Q1 2021 Jan 1, 2021 – Mar 31, 2021 · Q2 2021 Apr 1, 2021 – Jun 30, 2021 · Q3 2021 Jul 1, 2021 – Sep 30, 2021 · Q4 2021 Oct 1, 2021 – Dec 31, 2021 · Q1 2022 Jan 1, 2022 – Mar 31, 2022 · Q2 2022 Apr 1, 2022 – Jun 30, 2022 · Q3 2022 Jul 1, 2022 – Sep 30, 2022 · Q4 2022 Oct 1, 2022 – Dec 31, 2022 · Q1 2023 Jan 1, 2023 – Mar 31, 2023 · Q2 2023 Apr 1, 2023 – Jun 30, 2023 · Q3 2023 Jul 1, 2023 – Sep 30, 2023 · Q4 2023 Oct 1, 2023 – Dec 31, 2023 · Q1 2024 Mar 9, 2024 – Mar 31, 2024 · Q2 2024 Apr 1, 2024 – Jun 30, 2024 · Q3 2024 Jul 1, 2024 – Sep 30, 2024 · Q4 2024 Oct 1, 2024 – Dec 31, 2024 · Q1 2025 Jan 1, 2025 – Mar 31, 2025 · Q2 2025 Apr 1, 2025 – Jun 30, 2025 · Q3 2025 Jul 1, 2025 – Sep 30, 2025 · Q4 2025 Oct 1, 2025 – Dec 31, 2025 · Q1 2026 Jan 1, 2026 – Mar 31, 2026 · Q2 2026 Apr 1, 2026 – Jun 30, 2026 · Q3 2026 Jul 1, 2026 – Sep 30, 2026 · Q4 2026 Oct 1, 2026 – present

    Earliest release in this history.

National baseline (GPCI 1.000), before sequestration.

When does this rate change?

CMS publishes a fee schedule release every quarter (January, April, July, October), and each is versioned here. See what changed each release, or get an email when a new release moves rates.

Sources: CMS Medicare Physician Fee Schedule Relative Value Files.

Did this answer your question about HCPCS J7321?

Tell us what you were trying to work out and we'll answer you or build the page that does.

Did this page answer your question?

Usage and related codes Copy link

Localis groups related codes for payment research; the grouping isn't the AMA's code families.