J0716
HCPCS Procedure Code
HCPCS code J0716 is the #6,425 most-billed Medicaid procedure code, with $66K in payments across 16 claims from 2018–2024. The national median cost per claim is $4,106.95.
Total Paid
$66K
0.00% of all spending
Total Claims
16
Providers
1
Avg Cost/Claim
$4K
National Cost Distribution
How much do providers bill per claim for J0716? Based on 1 providers billing this code nationally.
Median
$4,106.95
Average
$4,106.95
Std Dev
—
Max
$4,106.95
Percentile Distribution (Cost per Claim)
50% of providers bill between $4,106.95 and $4,106.95 per claim for this code.
90% bill between $4,106.95 and $4,106.95.
Top 1% bill above $4,106.95.
About This Procedure
HCPCS code J0716 was billed by 1 providers across 16 claims, totaling $66K in Medicaid payments from 2018–2024. This code was used for 14 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
$4,106.95
Providers Billing
1
National Spending
$66K
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.