J1556
HCPCS Procedure Code
HCPCS code J1556 is the #5,594 most-billed Medicaid procedure code, with $171K in payments across 65 claims from 2018–2024. The national median cost per claim is $2,627.74.
Total Paid
$171K
0.00% of all spending
Total Claims
65
Providers
1
Avg Cost/Claim
$3K
National Cost Distribution
How much do providers bill per claim for J1556? Based on 1 providers billing this code nationally.
Median
$2,627.74
Average
$2,627.74
Std Dev
—
Max
$2,627.74
Percentile Distribution (Cost per Claim)
50% of providers bill between $2,627.74 and $2,627.74 per claim for this code.
90% bill between $2,627.74 and $2,627.74.
Top 1% bill above $2,627.74.
About This Procedure
HCPCS code J1556 was billed by 1 providers across 65 claims, totaling $171K in Medicaid payments from 2018–2024. This code was used for 24 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
$2,627.74
Providers Billing
1
National Spending
$171K
Avg/Median Ratio
1.00×
Normal distribution
Provider Coverage
We have 1 providers billing this code in our dataset. Individual provider breakdowns are available for top-spending procedure codes.