J0638
HCPCS Procedure Code
HCPCS code J0638 is the #1,537 most-billed Medicaid procedure code, with $19.8M in payments across 910 claims from 2018–2024. The national median cost per claim is $21,803.97.
Total Paid
$19.8M
0.00% of all spending
Total Claims
910
Providers
1
Avg Cost/Claim
$22K
National Cost Distribution
How much do providers bill per claim for J0638? Based on 1 providers billing this code nationally.
Median
$21,803.97
Average
$21,803.97
Std Dev
—
Max
$21,803.97
Percentile Distribution (Cost per Claim)
50% of providers bill between $21,803.97 and $21,803.97 per claim for this code.
90% bill between $21,803.97 and $21,803.97.
Top 1% bill above $21,803.97.
About This Procedure
HCPCS code J0638 was billed by 1 providers across 910 claims, totaling $19.8M in Medicaid payments from 2018–2024. This code was used for 793 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
$21,803.97
Providers Billing
1
National Spending
$19.8M
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.