Statistical flags indicate unusual patterns — not proof of fraud or wrongdoing. Read our methodology

#3863 of 11K

J0180

HCPCS Procedure Code

HCPCS code J0180 is the #3,863 most-billed Medicaid procedure code, with $1.1M in payments across 51 claims from 2018–2024. The national median cost per claim is $21,038.91.

Total Paid

$1.1M

0.00% of all spending

Total Claims

51

Providers

1

Avg Cost/Claim

$21K

National Cost Distribution

How much do providers bill per claim for J0180? Based on 1 providers billing this code nationally.

Median

$21,038.91

Average

$21,038.91

Std Dev

Max

$21,038.91

Percentile Distribution (Cost per Claim)

p10
$21,038.91
p25
$21,038.91
Median
$21,038.91
p75
$21,038.91
p90
$21,038.91
p95
$21,038.91
p99
$21,038.91

50% of providers bill between $21,038.91 and $21,038.91 per claim for this code.

90% bill between $21,038.91 and $21,038.91.

Top 1% bill above $21,038.91.

About This Procedure

HCPCS code J0180 was billed by 1 providers across 51 claims, totaling $1.1M in Medicaid payments from 2018–2024. This code was used for 36 unique beneficiaries.

Fraud Risk Context

Injectable drug codes carry high per-claim costs and have been involved in drug diversion and upcoding schemes.

Source: HHS OIG Reports

Risk Assessment

Billing Statistics

Median Cost/Claim

$21,038.91

Providers Billing

1

National Spending

$1.1M

Avg/Median Ratio

1.00×

Normal distribution

Provider Coverage

We have 1 providers billing this code in our dataset. Individual provider breakdowns are available for top-spending procedure codes.