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

#956 of 11K

J1439

HCPCS Procedure Code

HCPCS code J1439 is the #956 most-billed Medicaid procedure code, with $54.5M in payments across 119K claims from 2018–2024. The national median cost per claim is $477.34.

Total Paid

$54.5M

0.00% of all spending

Total Claims

119K

Providers

257

Avg Cost/Claim

$458

National Cost Distribution

How much do providers bill per claim for J1439? Based on 248 providers billing this code nationally.

Median

$477.34

Average

$485.92

Std Dev

$312.28

Max

$2,011.61

Percentile Distribution (Cost per Claim)

p10
$70.68
p25
$259.01
Median
$477.34
p75
$671.67
p90
$816.97
p95
$931.19
p99
$1,348.80

50% of providers bill between $259.01 and $671.67 per claim for this code.

90% bill between $70.68 and $816.97.

Top 1% bill above $1,348.80.

About This Procedure

HCPCS code J1439 was billed by 257 providers across 119K claims, totaling $54.5M in Medicaid payments from 2018–2024. This code was used for 77K 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

$477.34

Providers Billing

248

National Spending

$54.5M

Avg/Median Ratio

1.02×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for J1439

#ProviderTotal Paid
11497737183$3.8M
2The Hospital Of Central Connecticut At New Britain General And Bradley

New Britain, CT · General Acute Care Hospital

$2.7M
31326124819$2.5M
4Hmh Hospitals Corporation

Hackensack, NJ · Ambulance

$2.3M
51427069368$1.8M
6Ahs Hospital Corp.

Summit, NJ · General Acute Care Hospital

$1.6M
7Maimonides Medical Center

Brooklyn, NY · General Acute Care Hospital

$1.5M
81396794574$1.5M
9Montefiore Medical Center

Bronx, NY · General Acute Care Hospital

$1.4M
101073665360$1.2M
111770690695$1.2M
121326046467$1.1M
13Svmc Holdings, Inc

Bridgeport, CT · General Acute Care Hospital

$1.1M
14County Of Ventura

Ventura, CA · Clinic/Center, Emergency Care

$1.1M
15The New York And Presbyterian Hospital

New York, NY · General Acute Care Hospital

$1.0M
161437230034$909K
17Hartford Hospital

Hartford, CT · General Acute Care Hospital

$859K
18Nyu Langone Hospitals

New York, NY · Clinic/Center, Oncology

$811K
19Englewood Hospital And Medical Center

Englewood, NJ · General Acute Care Hospital

$797K
201528018389$760K

Showing top 20 of 257 providers billing this code