Monovisc Cost: $626.14 for One Syringe at Medicare's Price
Monovisc is a single injection, and at Medicare's published rate for October through December 2026 the gel alone is allowed at $626.14. That is the most expensive single dose of any knee gel Medicare pays for. Add the injection and the whole thing is $694.95, of which your share on Original Medicare is $138.99.
- Monovisc bills as 1 unit of J7327, priced per dose rather than per milligram. One syringe, one unit, $626.14. If your statement shows more than one unit per knee, that is the error to chase.
- It is the most-used knee gel in Medicare and the only major one still growing: $71.1 million and 78,963 claims in 2024, up 56% in claims since 2020 while the rest of the class shrank.
- Per milligram it is not the expensive one. The dose is 88 mg, nearly double most products, so you are paying for more molecule rather than a higher markup.
What One Monovisc Injection Costs
| 2026 Medicare payment limit, per dose (code J7327) | $626.144 |
| Units billed per knee | 1 |
| Medicare-allowed drug cost | $626.14 |
| Injection procedure in an office (CPT 20610) | $68.81 |
| Total allowed, one knee | $694.95 |
| Your 20% on Original Medicare | $138.99 |
Both knees doubles it to $1,389.90 allowed and $277.98 out of pocket, and each knee needs its own syringe. Add the $283 Part B deductible if you have not met it for the year.
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Why the Highest Dose Price Is Not the Same as the Highest Markup
It is easy to look at $626.14 and conclude Monovisc is the gouge of the category. The per-milligram math says otherwise. Monovisc delivers 88 mg of cross-linked hyaluronan in one 4 mL syringe, which is roughly double what most products put in a single shot. Priced per milligram of actual gel, it sits in the middle of the pack.
| Product | Allowed per mg of gel | Dose per injection |
|---|---|---|
| Synojoynt | $3.115 | 20 mg |
| TriVisc | $4.207 | 25 mg |
| GenVisc 850 | $4.231 | 25 mg |
| Gelsyn-3 | $5.500 | 16.8 mg |
| Synvisc / Synvisc-One | $6.011 | 16 or 48 mg |
| Durolane | $6.314 | 60 mg |
| Monovisc | $7.115 | 88 mg |
| Triluron | $10.188 | 20 mg |
| Hymovis | $17.940 | 24 mg |
Monovisc's $7.115 per milligram is derived by dividing the $626.144 per-dose limit by the 88 mg label dose, so treat it as a comparison aid rather than a billing figure. Hymovis costs 2.5 times more per milligram than Monovisc. Whether more milligrams in one shot produces more relief is a separate question, and the evidence does not settle it.
The Comparison That Actually Matters: Monovisc vs Orthovisc
Monovisc and Orthovisc come from the same manufacturer, Anika Therapeutics. Monovisc is the one-shot version; Orthovisc is up to four weekly injections. If your clinic offers both, this is the decision in front of you, and here the single shot is the cheaper one.
| Monovisc | Orthovisc | |
|---|---|---|
| Injections in a course | 1 | 4 |
| Allowed per dose | $626.14 | $116.79 |
| Gel for the course | $626.14 | $467.17 |
| Injection fees | $68.81 | $275.22 |
| Total course | $694.95 | $742.39 |
| Your 20% | $138.99 | $148.48 |
Monovisc comes out $47.44 cheaper for the course and saves three trips to the office. The gel is cheaper per dose with Orthovisc, but four injection fees of $68.81 more than erase it. This is the one place in the category where the convenient option is also the frugal one.
Monovisc Barely Got Cheaper While the Rest of the Class Collapsed
Medicare recalculates these limits every quarter from actual market selling prices. Across all knee gels, Part B spending fell from $746.0 million in 2021 to $413.7 million in 2024 while the number of claims barely moved, meaning prices dropped roughly 45% as a class. Monovisc did not follow.
| Year | Allowed per dose | Claims | Medicare spending |
|---|---|---|---|
| 2020 | $737.90 | 50,569 | $49.0M |
| 2021 | $753.18 | 51,839 | $51.8M |
| 2022 | $753.18 | 63,225 | $63.3M |
| 2023 | $699.88 | 71,020 | $65.9M |
| 2024 | $676.33 | 78,963 | $71.1M |
| Q4 2026 | $626.14 | n/a | n/a |
Down 17% from its 2021 peak against a 45% decline for the class, with claims up 56% and spending up every single year. Gel-One, by contrast, fell from $1,189.17 per dose in 2021 to $509.81 in 2024. Monovisc held its price and grew volume anyway.
Checking a Monovisc Bill
Unit count: it should be 1 per knee
J7327 is priced per dose, not per milligram. One syringe into one knee is one unit. If the claim shows 4 units (someone counting milliliters) or 88 units (someone counting milligrams), the charge is wrong by thousands of dollars. At $626.144 a unit, 4 units is $2,504.58 instead of $626.14.
No EJ modifier should appear
EJ marks subsequent injections in a series. Monovisc is a one-injection series, so there is never a subsequent injection to mark. An EJ on a Monovisc claim means something about the series was coded wrong.
One office visit, not two
An evaluation and management charge is reasonable at the visit where the decision to inject was made. If you were seen, sent home, and brought back purely for the shot, two visit charges for one injection is worth asking about.
The coverage criteria, before the needle
X-ray evidence of osteoarthritis, three months of failed conservative therapy, and a failed or contraindicated steroid injection all have to be in your chart first. Monovisc is not covered as a first treatment. A denial after the injection leaves you owing the full $694.95 rather than $138.99.
If you are on a Medicare Advantage plan
Advantage plans cover the same treatment but add prior authorization and often step therapy, meaning they can require a specific cheaper product before approving Monovisc. If you were switched to a different gel for cost reasons, check the full product table, because some substitutions cost more, not less. A denial is appealable. See how to appeal.
Common Questions
How much does Monovisc cost?
At Medicare's payment limit for October through December 2026, the gel is $626.14 for the single 88 mg syringe. With the office injection fee of $68.81 the total allowed is $694.95, and your coinsurance on Original Medicare is $138.99. Both knees is $1,389.90 allowed and $277.98 out of pocket. Commercial insurance and cash prices run higher than Medicare rates.
Does Medicare cover Monovisc?
Yes, under Part B, for osteoarthritis of the knee. You need X-ray evidence of osteoarthritis, at least three months of documented failed conservative therapy, and failure of or a contraindication to a steroid injection first. It is not covered as the initial treatment, and a repeat injection requires six months to have elapsed and that the first one actually helped.
How many units of J7327 should be billed?
One unit per knee. J7327 is priced per dose rather than per milligram, so a single 4 mL, 88 mg syringe is one unit at $626.144. Bilateral treatment is two units, one per knee, each with its own syringe. Unit counts of 4 or 88 are billing errors worth disputing.
Is Monovisc better than a three-shot gel?
No head-to-head evidence establishes that. It delivers more hyaluronan in one visit, and reviewing the trial literature in 2026 a Medicare contractor found the effect of hyaluronic acid varies widely across products and studies without consistently exceeding the threshold for a clinically meaningful difference. The honest case for Monovisc is one visit instead of three or four, and against Orthovisc from the same maker it is also $47.44 cheaper.
Is there a cheaper alternative to Monovisc?
Yes, several. Synvisc-One is also a single injection and the cheapest full course in the category at $357.34 allowed, $337.61 less than Monovisc. Synojoynt is $393.32 across three injections. All are hyaluronic acid into the same joint. Clinics usually stock one or two products, so ask what they carry and ask whether a cheaper one is available.
What does Monovisc cost without insurance?
Cash prices are set by the practice and typically land above Medicare's $694.95 all-in, often $900 to $1,500 at an office and more at a hospital outpatient clinic. Medicare's allowed amount is the right anchor for a self-pay negotiation, so ask for the all-in price including the gel and the injection before you agree, and ask what it would be at Medicare rates.
Sources
- CMS, October 2026 Medicare Part B Payment Limit File, effective October 1 through December 31, 2026. J7327 at $626.144 per dose.
- CMS, CY2026 Physician Fee Schedule Relative Value File, October release. CPT 20610 at 2.06 non-facility RVUs, conversion factor $33.4009.
- CMS, Medicare Part B Spending by Drug, 2024 release. J7327 spending, claims, and average allowed per dose, 2020 through 2024.
- CMS Medicare Coverage Database, LCD L39260, Billing and Coding Article A59030, and Proposed LCD DL40456, Hyaluronic Acid Injections for Knee Osteoarthritis.
- Monovisc instructions for use (Anika Therapeutics), for the 88 mg per 4 mL single-injection dose.