J2004
HCPCS Procedure Code
HCPCS code J2004 is the #7,342 most-billed Medicaid procedure code, with $20K in payments across 14K claims from 2018–2024. The national median cost per claim is $0.38. Costs vary widely — the 90th percentile is $3.02 per claim, 7.9× the median.
Total Paid
$20K
0.00% of all spending
Total Claims
14K
Providers
254
Avg Cost/Claim
$1
National Cost Distribution
How much do providers bill per claim for J2004? Based on 100 providers billing this code nationally.
Median
$0.38
Average
$4.81
Std Dev
$34.10
Max
$340.31
Percentile Distribution (Cost per Claim)
50% of providers bill between $0.09 and $1.10 per claim for this code.
90% bill between $0.02 and $3.02.
Top 1% bill above $34.49.
About This Procedure
HCPCS code J2004 was billed by 254 providers across 14K claims, totaling $20K in Medicaid payments from 2018–2024. This code was used for 13K 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
$0.38
Providers Billing
100
National Spending
$20K
Avg/Median Ratio
12.66×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for J2004
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1629007430 | $15K |
| 2 | Providence Health & Services Washington Anchorage, AK · General Acute Care Hospital | $1K |
| 3 | 1336333954 | $645 |
| 4 | 1417975061 | $497 |
| 5 | 1104856095 | $440 |
| 6 | Arthur G James Cancer Hospital And Research Institute Columbus, OH · Special Hospital | $256 |
| 7 | 1649373887 | $230 |
| 8 | Montefiore Medical Center Bronx, NY · General Acute Care Hospital | $198 |
| 9 | Norton Hospitals, Inc Louisville, KY · General Acute Care Hospital | $173 |
| 10 | 1003067679 | $170 |
| 11 | 1740413798 | $169 |
| 12 | 1689282147 | $157 |
| 13 | Nyu Langone Hospitals New York, NY · Clinic/Center, Oncology | $114 |
| 14 | 1730264128 | $94 |
| 15 | 1265539498 | $88 |
| 16 | Children's Hospital Of Wisconsin, Inc. Milwaukee, WI · Dentist, Pediatric Dentistry | $79 |
| 17 | Long Island Jewish Medical Center New Hyde Park, NY · General Acute Care Hospital | $75 |
| 18 | 1528009412 | $66 |
| 19 | 1427030774 | $65 |
| 20 | 1730692344 | $57 |
Showing top 20 of 254 providers billing this code