#693 of 11K

J1050

Injection, medroxyprogesterone acetate, one milligram

Injection, medroxyprogesterone acetate, one milligram is the #693 most-billed Medicaid procedure code, with $103.6M in payments across 2.7M claims from 2018–2024. The national median cost per claim is $41.92.

Total Paid

$103.6M

0.01% of all spending

Total Claims

2.7M

Providers

Avg Cost/Claim

$38

National Cost Distribution

How much do providers bill per claim for J1050? Based on 3K providers billing this code nationally.

Median

$41.92

Average

$43.06

Std Dev

$33.75

Max

$463.46

Percentile Distribution (Cost per Claim)

p10

$0.83

p25

$14.55

Median

$41.92

p75

$69.20

p90

$81.79

p95

$88.62

p99

$111.85

50% of providers bill between $14.55 and $69.20 per claim for this code.

90% bill between $0.83 and $81.79.

Top 1% bill above $111.85.

About This Procedure

HCPCS code J1050 (Injection, medroxyprogesterone acetate, one milligram) was billed by 3K providers across 2.7M claims, totaling $103.6M in Medicaid payments from 2018–2024. This code was used for 2.5M 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

$41.92

Providers Billing

National Spending

$103.6M

Avg/Median Ratio

1.03×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for J1050

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1174633143	$2.4M	$52.36	1.2× median	Above Median
2	1629057146	$2.0M	$92.07	2.2× median	Top 10%
3	1184780355	$1.4M	$77.30	1.8× median	Above 75th
4	The Metrohealth System Cleveland, OH · General Acute Care Hospital	$1.2M	$69.41	1.7× median	Above 75th
5	1821372277	$1.1M	$52.61	1.3× median	Above Median
6	1114264660	$986K	$19.37	0.5× median	Below Median
7	1891743092	$975K	$41.87	1.0× median	Below Median
8	1912943184	$900K	$110.55	2.6× median	Top 10%
9	1235242082	$870K	$68.50	1.6× median	Above Median
10	1174731806	$823K	$83.88	2.0× median	Top 10%
11	1982747184	$750K	$13.03	0.3× median	Below Median
12	State Of New Mexico Santa Fe, NM · Public Health or Welfare	$740K	$88.15	2.1× median	Top 10%
13	1083700686	$731K	$28.03	0.7× median	Below Median
14	Planned Parenthood Of Greater Ohio Akron, OH · Clinic/Center Ambulatory Family Planning Facility	$614K	$85.42	2.0× median	Top 10%
15	1831570860	$585K	$106.94	2.6× median	Top 10%
16	1316015449	$567K	$88.55	2.1× median	Top 10%
17	1629186374	$562K	$97.71	2.3× median	Top 10%
18	University Hospitals Cleveland Medical Center Cleveland, OH · General Acute Care Hospital	$551K	$78.90	1.9× median	Above 75th
19	1538152491	$548K	$81.97	2.0× median	Top 10%
20	1366525370	$543K	$19.88	0.5× median	Below Median

Showing top 20 of 3K providers billing this code

Related Procedures

J1040$7.0M J1055$0

← All procedures Top providers →