J0688
HCPCS Procedure Code
HCPCS code J0688 is the #6,074 most-billed Medicaid procedure code, with $98K in payments across 33K claims from 2018–2024. The national median cost per claim is $0.73. Costs vary widely — the 90th percentile is $10.99 per claim, 15.1× the median.
Total Paid
$98K
0.00% of all spending
Total Claims
33K
Providers
141
Avg Cost/Claim
$3
National Cost Distribution
How much do providers bill per claim for J0688? Based on 64 providers billing this code nationally.
Median
$0.73
Average
$18.25
Std Dev
$113.20
Max
$905.06
Percentile Distribution (Cost per Claim)
50% of providers bill between $0.10 and $3.20 per claim for this code.
90% bill between $0.02 and $10.99.
Top 1% bill above $385.82.
About This Procedure
HCPCS code J0688 was billed by 141 providers across 33K claims, totaling $98K in Medicaid payments from 2018–2024. This code was used for 27K 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
$0.73
Providers Billing
64
National Spending
$98K
Avg/Median Ratio
25.00×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for J0688
| # | Provider | Total Paid |
|---|---|---|
| 1 | Rhode Island Hospital Providence, RI · General Acute Care Hospital | $64K |
| 2 | 1689282147 | $8K |
| 3 | 1265423917 | $4K |
| 4 | 1538244918 | $4K |
| 5 | St Elizabeth Medical Center, Inc Edgewood, KY · Portable X-Ray and/or Other Portable Diagnostic Imaging Supplier | $3K |
| 6 | 1265539498 | $2K |
| 7 | University Of Kentucky Lexington, KY · General Acute Care Hospital | $2K |
| 8 | 1437150984 | $1K |
| 9 | 1568452290 | $919 |
| 10 | 1477671535 | $763 |
| 11 | 1710109186 | $756 |
| 12 | 1477587632 | $747 |
| 13 | 1013981554 | $655 |
| 14 | Brigham & Womens Hospital Inc. Boston, MA · General Acute Care Hospital | $646 |
| 15 | 1043354111 | $507 |
| 16 | 1235139312 | $458 |
| 17 | Childrens Hospital Of Los Angeles Los Angeles, CA · Case Manager/Care Coordinator | $431 |
| 18 | University Of California Irvine Orange, CA · General Acute Care Hospital | $416 |
| 19 | Arthur G James Cancer Hospital And Research Institute Columbus, OH · Special Hospital | $336 |
| 20 | The General Hospital Corporation Boston, MA · General Acute Care Hospital | $313 |
Showing top 20 of 141 providers billing this code