Synvisc Cost: The Same Gel Costs $137.61 More as Three Shots
Synvisc and Synvisc-One are the same material in the same total amount, 48 mg of hylan G-F 20, billed under the same code at the same rate. Medicare allows $288.53 of gel either way. But the three-injection version costs $494.95 all in and the one-injection version costs $357.34, because you pay the injection fee three times instead of once. Synvisc-One is the cheapest full course of any knee gel Medicare pays for.
- Both versions bill under J7325 at $6.011 per milligram. Synvisc is 16 units three times; Synvisc-One is 48 units once. Same 48 milligrams, same $288.53 of gel.
- The entire price difference is two extra office injection fees at $68.81 each. Nothing clinical is being bought with that money.
- Synvisc is made from chicken comb material. If you have a poultry or egg allergy, that is a real reason to pick a different product, and one of the few clinical reasons to pay more.
Synvisc vs Synvisc-One, at Medicare's Rates
Medicare's payment limit for October through December 2026 is $6.011 per milligram of hylan G-F 20 under code J7325, which covers both versions. The injection procedure in a doctor's office (CPT 20610) is $68.81 each time.
| Synvisc | Synvisc-One | |
|---|---|---|
| Injections | 3, one week apart | 1 |
| Dose each | 16 mg / 2 mL | 48 mg / 6 mL |
| Units billed each time | 16 | 48 |
| Total hylan G-F 20 | 48 mg | 48 mg |
| Gel cost for the course | $288.53 | $288.53 |
| Injection fees | $206.42 | $68.81 |
| Total allowed | $494.95 | $357.34 |
| Your 20% on Original Medicare | $98.99 | $71.47 |
The gel line is identical to the cent. The gap of $137.61 is precisely two injection fees, and your share of it is $27.52. Both knees doubles both numbers. If a clinic offers you the three-shot schedule, asking whether they stock Synvisc-One is a reasonable question with a specific dollar answer attached.
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Most People Already Get the Cheaper Version
Because both products share one billing code, Medicare's claims data shows how the mix actually breaks down. In 2024 the average claim under J7325 carried about 48 units, which is the Synvisc-One dose rather than Synvisc's 16. The market has largely moved to the single injection, and in this case the convenient choice and the cheap choice are the same one.
| Year | Allowed per mg | Claims | Patients | Spending |
|---|---|---|---|---|
| 2020 | $10.67 | 130,639 | 81,346 | $63.1M |
| 2021 | $10.56 | 133,725 | 83,641 | $64.8M |
| 2022 | $10.06 | 127,101 | 81,013 | $59.7M |
| 2023 | $9.29 | 125,654 | 81,234 | $56.2M |
| 2024 | $8.83 | 122,780 | 78,240 | $51.8M |
| Q4 2026 | $6.011 | n/a | n/a | n/a |
The price per milligram has fallen 44% since 2020, from $10.67 to $6.011. Synvisc has been on the US market since 1997, which gives it the longest track record in the category and also means it is competing with a dozen newer products on price. Your coinsurance fell with it: the 48 mg of gel in a full course was allowed at $512.16 in 2020 and is $288.53 now, taking your share of the gel from $102.43 down to $57.71.
The One Good Reason to Choose Something Else
Hylan G-F 20, the material in both Synvisc products, is derived from chicken combs. The labeling warns against use in patients with allergies to avian proteins, feathers, or egg products. If that is you, this is not a cost decision, and the alternative is a product made by bacterial fermentation rather than from birds.
| Option | Source | Course allowed | Your 20% |
|---|---|---|---|
| Synvisc-One | Avian (chicken comb) | $357.34 | $71.47 |
| Synvisc | Avian (chicken comb) | $494.95 | $98.99 |
| Euflexxa | Bacterial fermentation | $517.23 | $103.45 |
Euflexxa is $159.89 more than Synvisc-One for the course, or $31.98 more out of your pocket. That is a small premium to avoid an allergen, and a poor reason to switch if you have no allergy.
Checking a Synvisc Bill
Units: 16 per shot for Synvisc, 48 for Synvisc-One
J7325 is priced per milligram, so the unit count equals the milligrams injected. A Synvisc claim showing 48 units for a single 2 mL syringe is a $192.35 overcharge on that line, and a Synvisc-One claim showing 6 units (someone counting milliliters) undercounts it. Per-milligram codes are where unit errors do the most damage.
An office visit on shots two and three
Medicare's instruction is that an evaluation and management service "should not be reported for subsequent injections unless there was a separately identifiable problem." On a three-shot Synvisc series, visits two and three generally should not carry one. At $95 to $136 each that is $190 to $272 worth disputing, which is more than the gel difference between products.
EJ on the first shot
EJ marks subsequent injections in a series and must not appear on the first. Each knee is its own series, so the first injection in each knee is an unmodified first injection. Synvisc-One claims should never carry EJ at all.
Three injection fees at a hospital outpatient clinic
A hospital facility fee lands on every visit. On a three-shot series that is three facility fees, which is the single biggest reason a Synvisc course can end up costing several times the $494.95 Medicare allows in an office. Ask to have the series done at an independent office.
Finish the series or it may not count
Medicare treats a series as a defined set of injections per knee, and a repeat series is only covered once six months have passed and the previous series actually improved your pain and function. If you stop a three-shot Synvisc course after one or two injections, you may have used up the window without getting a documented response. Talk to the office about the schedule before you start rather than after. See the full coverage criteria.
Common Questions
How much does Synvisc cost?
At Medicare's rate for October through December 2026, a three-injection Synvisc course is allowed at $494.95 including the injection fees, and your coinsurance on Original Medicare is $98.99. Synvisc-One, the single-injection version with the same total dose, is $357.34 allowed and $71.47 to you. Add the $283 Part B deductible if you have not met it.
Is Synvisc-One cheaper than Synvisc?
Yes, by $137.61 for the course, and the gel costs exactly the same. Both deliver 48 mg of hylan G-F 20 billed under J7325 at $6.011 per milligram, so $288.53 of gel either way. The difference is that Synvisc-One is injected once and Synvisc three times, and each injection carries a $68.81 procedure fee. Your share of the difference is $27.52.
Does Medicare cover Synvisc?
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 including both non-drug and drug treatment, and failure of or a contraindication to a steroid injection first. Synvisc is not covered as the initial treatment, and a repeat series requires six months to have elapsed and that the prior series helped.
How many units of J7325 should be on my bill?
J7325 is billed per milligram. Synvisc is 16 units per injection, three times. Synvisc-One is 48 units, once. A full Synvisc course totals 48 units across three claims and a Synvisc-One course is 48 units on one claim. If a single Synvisc injection shows 48 units, that line is overcharged by $192.35.
Is Synvisc safe if I am allergic to eggs or poultry?
Hylan G-F 20 is derived from chicken combs, and the labeling warns against use in patients with allergies to avian proteins, feathers, or egg products. Tell the office about any poultry or egg allergy before the injection. Euflexxa is produced by bacterial fermentation instead, and costs $517.23 for the course against Synvisc-One's $357.34.
What is the cheapest knee gel injection?
Synvisc-One, at $357.34 for the full course at Medicare's October 2026 rates, with Synojoynt next at $393.32. The most expensive is Hymovis at $998.73. All are hyaluronic acid injected into the same joint, so the range reflects pricing rather than any demonstrated difference in how well they work. See the full comparison of all 16 products.
Sources
- CMS, October 2026 Medicare Part B Payment Limit File, effective October 1 through December 31, 2026. J7325 at $6.011 per milligram.
- 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. J7325 spending, claims, beneficiaries, and average allowed per unit, 2020 through 2024.
- CMS Medicare Coverage Database, LCD L39260, Billing and Coding Article A59030, and Proposed LCD DL40456, Hyaluronic Acid Injections for Knee Osteoarthritis.
- Synvisc and Synvisc-One prescribing information (Genzyme, a Sanofi company), for the 16 mg per 2 mL three-injection and 48 mg per 6 mL single-injection regimens and the avian protein warning.