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

#7416 of 11K

J0873

HCPCS Procedure Code

HCPCS code J0873 is the #7,416 most-billed Medicaid procedure code, with $18K in payments across 48 claims from 2018–2024. The national median cost per claim is $384.71.

Total Paid

$18K

0.00% of all spending

Total Claims

48

Providers

1

Avg Cost/Claim

$385

National Cost Distribution

How much do providers bill per claim for J0873? Based on 1 providers billing this code nationally.

Median

$384.71

Average

$384.71

Std Dev

Max

$384.71

Percentile Distribution (Cost per Claim)

p10
$384.71
p25
$384.71
Median
$384.71
p75
$384.71
p90
$384.71
p95
$384.71
p99
$384.71

50% of providers bill between $384.71 and $384.71 per claim for this code.

90% bill between $384.71 and $384.71.

Top 1% bill above $384.71.

About This Procedure

HCPCS code J0873 was billed by 1 providers across 48 claims, totaling $18K in Medicaid payments from 2018–2024. This code was used for 16 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

$384.71

Providers Billing

1

National Spending

$18K

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.