J0184
HCPCS Procedure Code
HCPCS code J0184 is the #7,613 most-billed Medicaid procedure code, with $13K in payments across 793 claims from 2018–2024. The national median cost per claim is $4.72. Costs vary widely — the 90th percentile is $54.67 per claim, 11.6× the median.
Total Paid
$13K
0.00% of all spending
Total Claims
793
Providers
9
Avg Cost/Claim
$17
National Cost Distribution
How much do providers bill per claim for J0184? Based on 6 providers billing this code nationally.
Median
$4.72
Average
$20.27
Std Dev
$38.79
Max
$99.15
Percentile Distribution (Cost per Claim)
50% of providers bill between $2.09 and $9.23 per claim for this code.
90% bill between $1.42 and $54.67.
Top 1% bill above $94.70.
About This Procedure
HCPCS code J0184 was billed by 9 providers across 793 claims, totaling $13K in Medicaid payments from 2018–2024. This code was used for 726 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
$4.72
Providers Billing
6
National Spending
$13K
Avg/Median Ratio
4.29×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for J0184
| # | Provider | Total Paid |
|---|---|---|
| 1 | Pikeville Medical Center Inc Pikeville, KY · General Acute Care Hospital | $12K |
| 2 | 1972523348 | $510 |
| 3 | The Metrohealth System Cleveland, OH · General Acute Care Hospital | $378 |
| 4 | The New York And Presbyterian Hospital New York, NY · General Acute Care Hospital | $258 |
| 5 | Memorial Hospital For Cancer And Allied Diseases New York, NY · Pharmacy | $208 |
| 6 | The New York And Presbyterian Hospital New York, NY · General Acute Care Hospital | $179 |
| 7 | Charleston Area Medical Center Inc Charleston, WV · General Acute Care Hospital | $0 |
| 8 | The Cooper Health System Camden, NJ · General Acute Care Hospital | $0 |
| 9 | 1780196345 | $0 |
Showing top 9 of 9 providers billing this code