J1557
HCPCS Procedure Code
HCPCS code J1557 is the #4,071 most-billed Medicaid procedure code, with $873K in payments across 183 claims from 2018–2024. The national median cost per claim is $4,908.01.
Total Paid
$873K
0.00% of all spending
Total Claims
183
Providers
2
Avg Cost/Claim
$5K
National Cost Distribution
How much do providers bill per claim for J1557? Based on 2 providers billing this code nationally.
Median
$4,908.01
Average
$4,908.01
Std Dev
$242.53
Max
$5,079.50
Percentile Distribution (Cost per Claim)
50% of providers bill between $4,822.26 and $4,993.75 per claim for this code.
90% bill between $4,770.81 and $5,045.20.
Top 1% bill above $5,076.07.
About This Procedure
HCPCS code J1557 was billed by 2 providers across 183 claims, totaling $873K in Medicaid payments from 2018–2024. This code was used for 65 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
$4,908.01
Providers Billing
2
National Spending
$873K
Avg/Median Ratio
1.00×
Normal distribution
Provider Coverage
We have 2 providers billing this code in our dataset. Individual provider breakdowns are available for top-spending procedure codes.