J1630
HCPCS Procedure Code
HCPCS code J1630 is the #3,696 most-billed Medicaid procedure code, with $1.3M in payments across 790K claims from 2018–2024. The national median cost per claim is $0.57. Costs vary widely — the 90th percentile is $5.87 per claim, 10.3× the median.
Total Paid
$1.3M
0.00% of all spending
Total Claims
790K
Providers
987
Avg Cost/Claim
$2
National Cost Distribution
How much do providers bill per claim for J1630? Based on 737 providers billing this code nationally.
Median
$0.57
Average
$3.11
Std Dev
$12.29
Max
$189.14
Percentile Distribution (Cost per Claim)
50% of providers bill between $0.09 and $2.17 per claim for this code.
90% bill between $0.01 and $5.87.
Top 1% bill above $46.93.
About This Procedure
HCPCS code J1630 was billed by 987 providers across 790K claims, totaling $1.3M in Medicaid payments from 2018–2024. This code was used for 647K 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
$0.57
Providers Billing
737
National Spending
$1.3M
Avg/Median Ratio
5.46×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for J1630
| # | Provider | Total Paid |
|---|---|---|
| 1 | University Of Utah Salt Lake City, UT · Clinic/Center, Dental | $129K |
| 2 | 1043220650 | $49K |
| 3 | 1306871223 | $42K |
| 4 | 1144228446 | $36K |
| 5 | St Josephs University Medical Center Inc. Paterson, NJ · General Acute Care Hospital | $35K |
| 6 | University Hospital Newark, NJ · General Acute Care Hospital | $32K |
| 7 | Owensboro Health Inc Owensboro, KY · General Acute Care Hospital | $31K |
| 8 | 1114367497 | $31K |
| 9 | Rhode Island Hospital Providence, RI · General Acute Care Hospital | $31K |
| 10 | Beth Israel Deaconess Medical Center, Inc. Boston, MA · General Acute Care Hospital | $28K |
| 11 | 1073665360 | $26K |
| 12 | Boston Medical Center Corporation Boston, MA · General Acute Care Hospital | $24K |
| 13 | The General Hospital Corporation Boston, MA · General Acute Care Hospital | $24K |
| 14 | 1194749580 | $23K |
| 15 | 1275583726 | $23K |
| 16 | 1528078581 | $23K |
| 17 | Trinitas Regional Medical Center Elizabeth, NJ · General Acute Care Hospital | $20K |
| 18 | 1104856095 | $20K |
| 19 | 1538141627 | $20K |
| 20 | Antelope Valley Health Care District Lancaster, CA · General Acute Care Hospital | $19K |
Showing top 20 of 987 providers billing this code