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Updated July 1st, 2026

ZILRETTA J Code: J3304

Injection, triamcinolone acetonide, preservative-free, extended-release, microsphere formulation, 1 mg

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Q4 2026 Medicare Payment Limit for J3304, effective October 1, 2026: $19.159 per HCPCS billing unit, down 0.6% from $19.28. From CMS's final file.

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Medicare Payment Limit ?
$19.28
/ HCPCS billing unit · Q3 2026
APC Payment Limit ?
$19.28
/ HCPCS billing unit · APC 9469
ASP ?
$•••.••
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WAC · AWP ?
$•••.••
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NDCs Crosswalked ?
1
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Drug & Product Overview

HCPCS Descriptor Injection, triamcinolone acetonide, preservative-free, extended-release, microsphere formulation, 1 mg
HCPCS Added Date January 1, 2019
Manufacturer Pacira Pharmaceuticals
Route of Administration Intra-Articular
Generic Status Single-Source; Branded
Dosage Type Single-Dose
Dosage Form Kit

About ZILRETTA

Zilretta is a medication aligned to the HCPCS J Code: J3304 for billing, pricing, and reimbursement purposes in the United States. It is an Orthopedic drug administered via the intra-articular route and manufactured by Pacira Pharmaceuticals.

According to CMS Drug Use Information: This medication is used to treat knee pain in people with a certain type of arthritis (osteoarthritis). It works by reducing your body's immune response. Triamcinolone belongs to a class of drugs known as corticosteroids. It helps to reduce pain and swelling in the knee.

Disclaimer: This is a summary and does not contain all possible information about this product. For complete information about this product or your specific health needs, ask your healthcare professional.

NDC Code Information

Based on publicly available CMS files. The list of NDCs below is not exhaustive.

NDC Code Drug Manufacturer Billing Units / Pkg Package Size
65250-0003-01 Zilretta Pacira Pharmaceuticals, Inc. 32 Kit
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ZILRETTA Pricing & Reimbursement

J3304 Private Payer Reimbursement
$18.49 / HCPCS unit as of Jan 2026

National median reimbursement across major commercial payers.

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UnitedHealthcare, BlueCross BlueShield, Aetna, Cigna

Historical Graphing and Billing Calculator

per HCPCS unit
As of Q3 2026

Triamcinolone Acetonide Extended-release Injectable Suspension 505(b)(2) Information:

HCPCS Code Manufacturer Active Ingredient HCPCS Description
J3304 Pacira Pharmaceuticals Triamcinolone Acetonide Extended-release Injectable Suspension Injection, triamcinolone acetonide, preservative-free, extended-release, microsphere formulation, 1 mg

ZILRETTA CPT Administration Codes

The below list of CPT codes is intended for informational purposes only and may not be exhaustive. CPT® codes and descriptions are copyright American Medical Association (AMA). All rights reserved.

CPT Code Description
20610 Arthrocentesis, aspiration and/or injection, major joint or bursa (eg, shoulder, hip, knee, subacromial bursa); without ultrasound guidance
20611 Arthrocentesis, aspiration and/or injection into a joint or bursa (eg, subacromial bursa), under ultrasound guidance with permanent recording and reporting.
JW / JZ modifiers apply

CMS has identified Zilretta (J3304) as a HCPCS code with single-dose containers. Therefore, the JW/JZ wastage modifiers could be required for billing purposes. Wastage billing guide →

ZILRETTA Medically Unlikely Edits (MUE)

The most billing units of J3304 Medicare will pay for one patient in one day, as published by CMS. 1 unit = 1 mg.

Practitioner Office & Hospital Outpatient
64 units / day
= 64 mg per day

MAI 2 · Date of Service Edit: Policy. Absolute per-day limit set by policy or regulation; units above it are not payable, and denials are not appealable on medical-necessity grounds. See all MUE limits →

mg Enter a dose to see how many billing units it is and whether it is under the limit.

ZILRETTA Clinical Information

Indications and drug classification.

Treated Diseases & Conditions

This list of indications is not exhaustive and may be subject to errors. The information on BuyandBill.com is intended for informational purposes only and should not be used for medical advice.

Osteoarthritis pain of the knee

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Frequently Asked Questions

Is there an available Zilretta billing and coding guide?
Billing and coding information for ZILRETTA can be found through Pacira Pharmaceuticals. Visit Here →
Are there any available Zilretta patient assistance programs?
ZILRETTA patient assistance information can be found through Pacira Pharmaceuticals. Visit Here →
Where can I find Zilretta prescribing information?
ZILRETTA prescribing information can be found at the link below. Please reach out to us if you believe this information to be innacurate or out of date. Visit Here →
Where can I find Zilretta side effect information?
Our team has not yet identified a source of side effects information for ZILRETTA. Please check back in a few weeks.
Does billing ZILRETTA require JZ/JW wastage modifiers?
CMS has identified ZILRETTA(J3304) as a HCPCS code with single-dose containers. Therefore, the JW/JZ wastage modifiers could be required for billing purposes. See CMS guidelines on use of the JZ and JW wastage modifiers below.

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