J0875
HCPCS Procedure Code
HCPCS code J0875 is the #3,477 most-billed Medicaid procedure code, with $1.6M in payments across 769 claims from 2018–2024. The national median cost per claim is $2,947.77.
Total Paid
$1.6M
0.00% of all spending
Total Claims
769
Providers
9
Avg Cost/Claim
$2K
National Cost Distribution
How much do providers bill per claim for J0875? Based on 9 providers billing this code nationally.
Median
$2,947.77
Average
$2,734.03
Std Dev
$1,161.05
Max
$4,538.54
Percentile Distribution (Cost per Claim)
50% of providers bill between $2,153.28 and $3,561.92 per claim for this code.
90% bill between $1,461.05 and $3,848.05.
Top 1% bill above $4,469.49.
About This Procedure
HCPCS code J0875 was billed by 9 providers across 769 claims, totaling $1.6M in Medicaid payments from 2018–2024. This code was used for 576 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
$2,947.77
Providers Billing
9
National Spending
$1.6M
Avg/Median Ratio
0.93×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for J0875
| # | Provider | Total Paid |
|---|---|---|
| 1 | Baptist Healthcare System Inc Corbin, KY · General Acute Care Hospital | $806K |
| 2 | The Lowell General Hospital Lowell, MA · Pharmacy, Institutional Pharmacy | $419K |
| 3 | 1275531956 | $99K |
| 4 | 1689761942 | $74K |
| 5 | Englewood Hospital And Medical Center Englewood, NJ · General Acute Care Hospital | $61K |
| 6 | Regents Of The University Of California Sacramento, CA · General Acute Care Hospital | $59K |
| 7 | 1184606600 | $55K |
| 8 | Pikeville Medical Center Inc Pikeville, KY · General Acute Care Hospital | $28K |
| 9 | Froedtert Memorial Lutheran Hospital, Inc. Milwaukee, WI · Clinic/Center, Radiology | $25K |
Showing top 9 of 9 providers billing this code