J0689
HCPCS Procedure Code
HCPCS code J0689 is the #4,932 most-billed Medicaid procedure code, with $350K in payments across 103K claims from 2018–2024. The national median cost per claim is $0.36. Costs vary widely — the 90th percentile is $6.61 per claim, 18.4× the median.
Total Paid
$350K
0.00% of all spending
Total Claims
103K
Providers
186
Avg Cost/Claim
$3
National Cost Distribution
How much do providers bill per claim for J0689? Based on 137 providers billing this code nationally.
Median
$0.36
Average
$2.51
Std Dev
$5.20
Max
$29.51
Percentile Distribution (Cost per Claim)
50% of providers bill between $0.08 and $2.25 per claim for this code.
90% bill between $0.04 and $6.61.
Top 1% bill above $26.87.
About This Procedure
HCPCS code J0689 was billed by 186 providers across 103K claims, totaling $350K in Medicaid payments from 2018–2024. This code was used for 78K 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
$0.36
Providers Billing
137
National Spending
$350K
Avg/Median Ratio
6.97×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for J0689
| # | Provider | Total Paid |
|---|---|---|
| 1 | St Elizabeth Medical Center, Inc Edgewood, KY · Portable X-Ray and/or Other Portable Diagnostic Imaging Supplier | $90K |
| 2 | 1154365062 | $64K |
| 3 | Arthur G James Cancer Hospital And Research Institute Columbus, OH · Special Hospital | $35K |
| 4 | 1740221795 | $29K |
| 5 | Umass Memorial Medical Center, Inc. Worcester, MA · General Acute Care Hospital | $26K |
| 6 | 1306871223 | $17K |
| 7 | Ohiohealth Corporation Columbus, OH · General Acute Care Hospital | $10K |
| 8 | 1689282147 | $10K |
| 9 | 1265539498 | $8K |
| 10 | The General Hospital Corporation Boston, MA · General Acute Care Hospital | $7K |
| 11 | Regents Of The University Of California Sacramento, CA · General Acute Care Hospital | $6K |
| 12 | Southcoast Hospitals Group, Inc New Bedford, MA · General Acute Care Hospital | $4K |
| 13 | 1538244918 | $4K |
| 14 | Boston Medical Center Corporation Boston, MA · General Acute Care Hospital | $3K |
| 15 | Rochester General Hospital Rochester, NY · Dentist, General Practice | $3K |
| 16 | Ahs Hospital Corp. Summit, NJ · General Acute Care Hospital | $3K |
| 17 | 1417919531 | $2K |
| 18 | 1518018191 | $2K |
| 19 | Kennedy University Hospital Inc. Stratford, NJ · General Acute Care Hospital | $2K |
| 20 | Ohio State University Hospitals Columbus, OH · General Acute Care Hospital | $1K |
Showing top 20 of 186 providers billing this code