J1729
HCPCS Procedure Code
HCPCS code J1729 is the #2,593 most-billed Medicaid procedure code, with $4.7M in payments across 12K claims from 2018–2024. The national median cost per claim is $462.84. Costs vary widely — the 90th percentile is $2,125.25 per claim, 4.6× the median.
Total Paid
$4.7M
0.00% of all spending
Total Claims
12K
Providers
16
Avg Cost/Claim
$406
National Cost Distribution
How much do providers bill per claim for J1729? Based on 14 providers billing this code nationally.
Median
$462.84
Average
$806.92
Std Dev
$908.91
Max
$2,485.17
Percentile Distribution (Cost per Claim)
50% of providers bill between $87.69 and $1,596.65 per claim for this code.
90% bill between $53.78 and $2,125.25.
Top 1% bill above $2,445.20.
About This Procedure
HCPCS code J1729 was billed by 16 providers across 12K claims, totaling $4.7M in Medicaid payments from 2018–2024. This code was used for 4K 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
$462.84
Providers Billing
14
National Spending
$4.7M
Avg/Median Ratio
1.74×
Moderately skewed
Top Providers Billing This Code
Ranked by total Medicaid payments for J1729
| # | Provider | Total Paid |
|---|---|---|
| 1 | Optum Women's And Children's Health, Llc Marietta, GA · Home Health | $3.9M |
| 2 | 1013942788 | $273K |
| 3 | 1063431195 | $138K |
| 4 | 1295842615 | $89K |
| 5 | 1538147202 | $88K |
| 6 | Aurora Medical Group, Inc. Milwaukee, WI · Internal Medicine | $51K |
| 7 | Henry Ford Health System Detroit, MI · General Acute Care Hospital | $46K |
| 8 | 1265418891 | $37K |
| 9 | Yale New Haven Hospital New Haven, CT · General Acute Care Hospital | $33K |
| 10 | 1962514877 | $30K |
| 11 | 1184780355 | $2K |
| 12 | 1467488148 | $2K |
| 13 | The New York And Presbyterian Hospital New York, NY · General Acute Care Hospital | $954 |
| 14 | 1194989574 | $295 |
| 15 | 1427007384 | $0 |
| 16 | 1639123284 | $0 |
Showing top 16 of 16 providers billing this code