J1171
HCPCS Procedure Code
HCPCS code J1171 is the #5,780 most-billed Medicaid procedure code, with $140K in payments across 108K claims from 2018–2024. The national median cost per claim is $0.71. Costs vary widely — the 90th percentile is $8.67 per claim, 12.2× the median.
Total Paid
$140K
0.00% of all spending
Total Claims
108K
Providers
1K
Avg Cost/Claim
$1
National Cost Distribution
How much do providers bill per claim for J1171? Based on 474 providers billing this code nationally.
Median
$0.71
Average
$4.47
Std Dev
$15.81
Max
$266.54
Percentile Distribution (Cost per Claim)
50% of providers bill between $0.09 and $2.95 per claim for this code.
90% bill between $0.02 and $8.67.
Top 1% bill above $61.08.
About This Procedure
HCPCS code J1171 was billed by 1K providers across 108K claims, totaling $140K in Medicaid payments from 2018–2024. This code was used for 76K 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
$0.71
Providers Billing
474
National Spending
$140K
Avg/Median Ratio
6.30×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for J1171
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1114367497 | $13K |
| 2 | 1063812907 | $11K |
| 3 | 1295181477 | $10K |
| 4 | Seventh-day Adventists Loma Linda University Medical Center Loma Linda, CA · General Acute Care Hospital | $7K |
| 5 | 1104856095 | $6K |
| 6 | Rhode Island Hospital Providence, RI · General Acute Care Hospital | $3K |
| 7 | 1326107319 | $3K |
| 8 | Uofl Health-louisville Inc Louisville, KY · Psychiatric Hospital | $3K |
| 9 | Regents Of The University Of California Sacramento, CA · General Acute Care Hospital | $3K |
| 10 | Providence Health & Services Washington Anchorage, AK · General Acute Care Hospital | $2K |
| 11 | 1801821376 | $2K |
| 12 | Vanderbilt University Medical Center Nashville, TN · Psychiatric Unit | $2K |
| 13 | 1144664954 | $2K |
| 14 | Arthur G James Cancer Hospital And Research Institute Columbus, OH · Special Hospital | $2K |
| 15 | University Medical Center, Inc Louisville, KY · Student in an Organized Health Care Education/Training Program | $2K |
| 16 | Norton Hospitals, Inc Louisville, KY · General Acute Care Hospital | $2K |
| 17 | University Of Kentucky Lexington, KY · General Acute Care Hospital | $2K |
| 18 | 1144389941 | $2K |
| 19 | 1447221742 | $2K |
| 20 | 1639523004 | $2K |
Showing top 20 of 1K providers billing this code