J0872
HCPCS Procedure Code
HCPCS code J0872 is the #7,072 most-billed Medicaid procedure code, with $29K in payments across 272 claims from 2018–2024. The national median cost per claim is $520.53.
Total Paid
$29K
0.00% of all spending
Total Claims
272
Providers
2
Avg Cost/Claim
$108
National Cost Distribution
How much do providers bill per claim for J0872? Based on 2 providers billing this code nationally.
Median
$520.53
Average
$520.53
Std Dev
$702.96
Max
$1,017.60
Percentile Distribution (Cost per Claim)
50% of providers bill between $272.00 and $769.07 per claim for this code.
90% bill between $122.88 and $918.19.
Top 1% bill above $1,007.66.
About This Procedure
HCPCS code J0872 was billed by 2 providers across 272 claims, totaling $29K in Medicaid payments from 2018–2024. This code was used for 28 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
$520.53
Providers Billing
2
National Spending
$29K
Avg/Median Ratio
1.00×
Normal distribution
Provider Coverage
We have 2 providers billing this code in our dataset. Individual provider breakdowns are available for top-spending procedure codes.