J0606
HCPCS Procedure Code
HCPCS code J0606 is the #1,381 most-billed Medicaid procedure code, with $25.0M in payments across 549K claims from 2018–2024. The national median cost per claim is $25.87. Costs vary widely — the 90th percentile is $276.12 per claim, 10.7× the median.
Total Paid
$25.0M
0.00% of all spending
Total Claims
549K
Providers
180
Avg Cost/Claim
$46
National Cost Distribution
How much do providers bill per claim for J0606? Based on 122 providers billing this code nationally.
Median
$25.87
Average
$91.95
Std Dev
$151.40
Max
$826.31
Percentile Distribution (Cost per Claim)
50% of providers bill between $7.15 and $96.67 per claim for this code.
90% bill between $2.07 and $276.12.
Top 1% bill above $754.80.
About This Procedure
HCPCS code J0606 was billed by 180 providers across 549K claims, totaling $25.0M in Medicaid payments from 2018–2024. This code was used for 44K 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
$25.87
Providers Billing
122
National Spending
$25.0M
Avg/Median Ratio
3.55×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for J0606
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1104844562 | $3.7M |
| 2 | 1235213463 | $1.9M |
| 3 | 1821520735 | $1.7M |
| 4 | 1225436199 | $1.6M |
| 5 | 1942293691 | $1.4M |
| 6 | 1134308489 | $922K |
| 7 | 1396283339 | $888K |
| 8 | 1063421212 | $875K |
| 9 | 1316127921 | $856K |
| 10 | 1366687055 | $693K |
| 11 | 1346522679 | $647K |
| 12 | Rector & Visitors Of The University Of Virginia Charlottesville, VA · General Acute Care Hospital | $619K |
| 13 | 1821065947 | $581K |
| 14 | 1073888699 | $539K |
| 15 | Central Florida Kidney Centers Inc Orlando, FL · Clinic/Center End-Stage Renal Disease (ESRD) Treatment | $520K |
| 16 | 1891788550 | $489K |
| 17 | 1104268325 | $382K |
| 18 | 1801830583 | $367K |
| 19 | 1730110578 | $354K |
| 20 | 1134399397 | $349K |
Showing top 20 of 180 providers billing this code