J1566
HCPCS Procedure Code
HCPCS code J1566 is the #6,585 most-billed Medicaid procedure code, with $54K in payments across 57 claims from 2018–2024. The national median cost per claim is $774.28.
Total Paid
$54K
0.00% of all spending
Total Claims
57
Providers
2
Avg Cost/Claim
$943
National Cost Distribution
How much do providers bill per claim for J1566? Based on 2 providers billing this code nationally.
Median
$774.28
Average
$774.28
Std Dev
$545.35
Max
$1,159.90
Percentile Distribution (Cost per Claim)
50% of providers bill between $581.47 and $967.09 per claim for this code.
90% bill between $465.78 and $1,082.77.
Top 1% bill above $1,152.19.
About This Procedure
HCPCS code J1566 was billed by 2 providers across 57 claims, totaling $54K in Medicaid payments from 2018–2024. This code was used for 27 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
$774.28
Providers Billing
2
National Spending
$54K
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.