J1720
HCPCS Procedure Code
HCPCS code J1720 is the #3,904 most-billed Medicaid procedure code, with $1.0M in payments across 116K claims from 2018–2024. The national median cost per claim is $7.26. Costs vary widely — the 90th percentile is $23.50 per claim, 3.2× the median.
Total Paid
$1.0M
0.00% of all spending
Total Claims
116K
Providers
162
Avg Cost/Claim
$9
National Cost Distribution
How much do providers bill per claim for J1720? Based on 135 providers billing this code nationally.
Median
$7.26
Average
$13.19
Std Dev
$29.81
Max
$307.57
Percentile Distribution (Cost per Claim)
50% of providers bill between $1.89 and $14.13 per claim for this code.
90% bill between $0.53 and $23.50.
Top 1% bill above $107.07.
About This Procedure
HCPCS code J1720 was billed by 162 providers across 116K claims, totaling $1.0M in Medicaid payments from 2018–2024. This code was used for 88K 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
$7.26
Providers Billing
135
National Spending
$1.0M
Avg/Median Ratio
1.82×
Moderately skewed
Top Providers Billing This Code
Ranked by total Medicaid payments for J1720
| # | Provider | Total Paid |
|---|---|---|
| 1 | University Of Utah Salt Lake City, UT · Clinic/Center, Dental | $142K |
| 2 | Children's Hospital Corporation Boston, MA · Clinic/Center | $115K |
| 3 | Hmh Hospitals Corporation Hackensack, NJ · Ambulance | $91K |
| 4 | University Of Kentucky Lexington, KY · General Acute Care Hospital | $75K |
| 5 | 1356307581 | $50K |
| 6 | West Virginia University Hospitals, Inc Morgantown, WV · Clinical Medical Laboratory | $44K |
| 7 | 1699874248 | $37K |
| 8 | 1528036019 | $32K |
| 9 | Charleston Area Medical Center Inc Charleston, WV · General Acute Care Hospital | $29K |
| 10 | City Of Hope National Medical Center Duarte, CA · General Acute Care Hospital | $29K |
| 11 | Arthur G James Cancer Hospital And Research Institute Columbus, OH · Special Hospital | $24K |
| 12 | Umass Memorial Medical Center, Inc. Worcester, MA · General Acute Care Hospital | $23K |
| 13 | Seventh-day Adventists Loma Linda University Medical Center Loma Linda, CA · General Acute Care Hospital | $23K |
| 14 | Mount Sinai Hospital New York, NY · Ambulance | $22K |
| 15 | Baystate Medical Center Inc Springfield, MA · General Acute Care Hospital | $21K |
| 16 | Dana-farber Cancer Institute, Inc. Boston, MA · General Acute Care Hospital | $19K |
| 17 | Vhs Childrens Hospital Of Michigan Inc Detroit, MI · Clinic/Center, Ambulatory Surgical | $18K |
| 18 | 1730254749 | $15K |
| 19 | Long Island Jewish Medical Center New Hyde Park, NY · General Acute Care Hospital | $15K |
| 20 | 1598875460 | $15K |
Showing top 20 of 162 providers billing this code