Statistical flags indicate unusual patterns — not proof of fraud or wrongdoing. Read our methodology

#3137 of 11K

J0739

HCPCS Procedure Code

HCPCS code J0739 is the #3,137 most-billed Medicaid procedure code, with $2.4M in payments across 1K claims from 2018–2024. The national median cost per claim is $3,408.09.

Total Paid

$2.4M

0.00% of all spending

Total Claims

1K

Providers

7

Avg Cost/Claim

$2K

National Cost Distribution

How much do providers bill per claim for J0739? Based on 6 providers billing this code nationally.

Median

$3,408.09

Average

$2,911.48

Std Dev

$1,468.99

Max

$3,869.01

Percentile Distribution (Cost per Claim)

p10
$1,463.49
p25
$3,027.00
Median
$3,408.09
p75
$3,764.37
p90
$3,862.87
p95
$3,865.94
p99
$3,868.40

50% of providers bill between $3,027.00 and $3,764.37 per claim for this code.

90% bill between $1,463.49 and $3,862.87.

Top 1% bill above $3,868.40.

About This Procedure

HCPCS code J0739 was billed by 7 providers across 1K claims, totaling $2.4M in Medicaid payments from 2018–2024. This code was used for 1K 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

$3,408.09

Providers Billing

6

National Spending

$2.4M

Avg/Median Ratio

0.85×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for J0739

#ProviderTotal Paid
11801495544$2.0M
21861496358$140K
31255523155$104K
41306898432$88K
5Yale New Haven Hospital

New Haven, CT · General Acute Care Hospital

$46K
61912541061$15
7Los Angeles Lgbt Center

Los Angeles, CA · Clinic/Center Federally Qualified Health Center (FQHC)

$0

Showing top 7 of 7 providers billing this code