J1628
HCPCS Procedure Code
HCPCS code J1628 is the #5,148 most-billed Medicaid procedure code, with $276K in payments across 47 claims from 2018–2024. The national median cost per claim is $5,875.56.
Total Paid
$276K
0.00% of all spending
Total Claims
47
Providers
1
Avg Cost/Claim
$6K
National Cost Distribution
How much do providers bill per claim for J1628? Based on 1 providers billing this code nationally.
Median
$5,875.56
Average
$5,875.56
Std Dev
—
Max
$5,875.56
Percentile Distribution (Cost per Claim)
50% of providers bill between $5,875.56 and $5,875.56 per claim for this code.
90% bill between $5,875.56 and $5,875.56.
Top 1% bill above $5,875.56.
About This Procedure
HCPCS code J1628 was billed by 1 providers across 47 claims, totaling $276K in Medicaid payments from 2018–2024. This code was used for 37 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
$5,875.56
Providers Billing
1
National Spending
$276K
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.