J0737
HCPCS Procedure Code
HCPCS code J0737 is the #7,863 most-billed Medicaid procedure code, with $9K in payments across 5K claims from 2018–2024. The national median cost per claim is $1.25. Costs vary widely — the 90th percentile is $4.54 per claim, 3.6× the median.
Total Paid
$9K
0.00% of all spending
Total Claims
5K
Providers
51
Avg Cost/Claim
$2
National Cost Distribution
How much do providers bill per claim for J0737? Based on 35 providers billing this code nationally.
Median
$1.25
Average
$2.41
Std Dev
$3.43
Max
$18.35
Percentile Distribution (Cost per Claim)
50% of providers bill between $0.62 and $2.75 per claim for this code.
90% bill between $0.35 and $4.54.
Top 1% bill above $14.99.
About This Procedure
HCPCS code J0737 was billed by 51 providers across 5K claims, totaling $9K in Medicaid payments from 2018–2024. This code was used for 3K 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
$1.25
Providers Billing
35
National Spending
$9K
Avg/Median Ratio
1.93×
Moderately skewed
Top Providers Billing This Code
Ranked by total Medicaid payments for J0737
| # | Provider | Total Paid |
|---|---|---|
| 1 | Childrens Hospital Of The Kings Daughters Inc Norfolk, VA · Social Worker, Clinical | $4K |
| 2 | Miami Valley Hospital Dayton, OH · General Acute Care Hospital | $1K |
| 3 | 1902839673 | $902 |
| 4 | Owensboro Health Inc Owensboro, KY · General Acute Care Hospital | $642 |
| 5 | University Of Kentucky Lexington, KY · General Acute Care Hospital | $495 |
| 6 | 1871588772 | $286 |
| 7 | Dayton Children's Hospital Dayton, OH · General Acute Care Hospital, Children | $277 |
| 8 | 1952476665 | $211 |
| 9 | Summa Health System Akron, OH · General Acute Care Hospital | $176 |
| 10 | 1538141627 | $158 |
| 11 | 1306991211 | $122 |
| 12 | Dayton Osteopathic Hospital Dayton, OH · General Acute Care Hospital | $120 |
| 13 | 1013981554 | $119 |
| 14 | 1871547703 | $100 |
| 15 | 1760488266 | $98 |
| 16 | Robert Wood Johnson University Hospital, Inc New Brunswick, NJ · General Acute Care Hospital | $93 |
| 17 | Kaiser Foundation Hospitals Downey, CA · General Acute Care Hospital | $75 |
| 18 | Ohio State University Hospitals Columbus, OH · General Acute Care Hospital | $73 |
| 19 | 1174793459 | $55 |
| 20 | Kaiser Foundation Hospitals Sacramento, CA · General Acute Care Hospital | $42 |
Showing top 20 of 51 providers billing this code