J1010
HCPCS Procedure Code
HCPCS code J1010 is the #4,353 most-billed Medicaid procedure code, with $640K in payments across 176K claims from 2018–2024. The national median cost per claim is $3.44. Costs vary widely — the 90th percentile is $9.72 per claim, 2.8× the median.
Total Paid
$640K
0.00% of all spending
Total Claims
176K
Providers
1K
Avg Cost/Claim
$4
National Cost Distribution
How much do providers bill per claim for J1010? Based on 936 providers billing this code nationally.
Median
$3.44
Average
$5.01
Std Dev
$6.81
Max
$66.91
Percentile Distribution (Cost per Claim)
50% of providers bill between $1.26 and $6.31 per claim for this code.
90% bill between $0.28 and $9.72.
Top 1% bill above $41.09.
About This Procedure
HCPCS code J1010 was billed by 1K providers across 176K claims, totaling $640K in Medicaid payments from 2018–2024. This code was used for 153K 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
$3.44
Providers Billing
936
National Spending
$640K
Avg/Median Ratio
1.46×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for J1010
| # | Provider | Total Paid |
|---|---|---|
| 1 | Montefiore Medical Center Bronx, NY · Anesthesiology | $17K |
| 2 | 1174884258 | $16K |
| 3 | 1821286766 | $12K |
| 4 | 1962696542 | $12K |
| 5 | 1720083769 | $11K |
| 6 | Southern California Permanente Medical Group Harbor City, CA · Health Maintenance Organization | $10K |
| 7 | 1336187475 | $10K |
| 8 | Arthritis & Rheumatology Associates Of South Jersey Pc Vineland, NJ · Internal Medicine Rheumatology | $9K |
| 9 | 1982702841 | $9K |
| 10 | 1275710964 | $8K |
| 11 | 1619952595 | $8K |
| 12 | Pikeville Medical Center Inc Pikeville, KY · General Acute Care Hospital | $8K |
| 13 | 1720017528 | $7K |
| 14 | 1760007330 | $7K |
| 15 | 1831312461 | $7K |
| 16 | 1346244126 | $6K |
| 17 | 1669123535 | $6K |
| 18 | 1578627782 | $6K |
| 19 | 1083785398 | $6K |
| 20 | 1740535368 | $6K |
Showing top 20 of 1K providers billing this code