J1725
HCPCS Procedure Code
HCPCS code J1725 is the #4,945 most-billed Medicaid procedure code, with $344K in payments across 406 claims from 2018–2024. The national median cost per claim is $1,747.02.
Total Paid
$344K
0.00% of all spending
Total Claims
406
Providers
2
Avg Cost/Claim
$847
National Cost Distribution
How much do providers bill per claim for J1725? Based on 2 providers billing this code nationally.
Median
$1,747.02
Average
$1,747.02
Std Dev
$1,520.00
Max
$2,821.82
Percentile Distribution (Cost per Claim)
50% of providers bill between $1,209.62 and $2,284.42 per claim for this code.
90% bill between $887.18 and $2,606.86.
Top 1% bill above $2,800.32.
About This Procedure
HCPCS code J1725 was billed by 2 providers across 406 claims, totaling $344K in Medicaid payments from 2018–2024. This code was used for 151 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
$1,747.02
Providers Billing
2
National Spending
$344K
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.