J0611
HCPCS Procedure Code
HCPCS code J0611 is the #9,201 most-billed Medicaid procedure code, with $234 in payments across 360 claims from 2018–2024. The national median cost per claim is $4.22.
Total Paid
$234
0.00% of all spending
Total Claims
360
Providers
13
Avg Cost/Claim
$1
National Cost Distribution
How much do providers bill per claim for J0611? Based on 2 providers billing this code nationally.
Median
$4.22
Average
$4.22
Std Dev
$2.28
Max
$5.83
Percentile Distribution (Cost per Claim)
50% of providers bill between $3.42 and $5.03 per claim for this code.
90% bill between $2.94 and $5.51.
Top 1% bill above $5.80.
About This Procedure
HCPCS code J0611 was billed by 13 providers across 360 claims, totaling $234 in Medicaid payments from 2018–2024. This code was used for 288 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
$4.22
Providers Billing
2
National Spending
$234
Avg/Median Ratio
1.00×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for J0611
| # | Provider | Total Paid |
|---|---|---|
| 1 | County Of Santa Clara San Jose, CA · Case Manager/Care Coordinator | $192 |
| 2 | 1427360700 | $42 |
| 3 | Brigham & Womens Hospital Inc. Boston, MA · General Acute Care Hospital | $0 |
| 4 | The General Hospital Corporation Boston, MA · General Acute Care Hospital | $0 |
| 5 | Rector & Visitors Of The University Of Virginia Charlottesville, VA · General Acute Care Hospital | $0 |
| 6 | Boston Medical Center Corporation Boston, MA · General Acute Care Hospital | $0 |
| 7 | Virginia Commonwealth University Health System Authority Richmond, VA · General Acute Care Hospital | $0 |
| 8 | Trustees Of The University Of Pennsylvania Philadelphia, PA · Community/Behavioral Health | $0 |
| 9 | Yuma Regional Medical Center Yuma, AZ · General Acute Care Hospital | $0 |
| 10 | Inova Health Care Services Falls Church, VA · Clinic/Center, Rehabilitation, Substance Use Disorder | $0 |
| 11 | Riverside Hospital Inc Newport News, VA · Psychiatric Hospital | $0 |
| 12 | Banner - University Medical Center Phoenix Phoenix, AZ · Clinic/Center, Sleep Disorder Diagnostic | $0 |
| 13 | 1578597993 | $0 |
Showing top 13 of 13 providers billing this code