J2260
HCPCS Procedure Code
HCPCS code J2260 is the #3,992 most-billed Medicaid procedure code, with $947K in payments across 27K claims from 2018–2024. The national median cost per claim is $35.65. Costs vary widely — the 90th percentile is $76.46 per claim, 2.1× the median.
Total Paid
$947K
0.00% of all spending
Total Claims
27K
Providers
14
Avg Cost/Claim
$35
National Cost Distribution
How much do providers bill per claim for J2260? Based on 14 providers billing this code nationally.
Median
$35.65
Average
$41.50
Std Dev
$24.34
Max
$79.26
Percentile Distribution (Cost per Claim)
50% of providers bill between $23.56 and $57.35 per claim for this code.
90% bill between $12.27 and $76.46.
Top 1% bill above $78.96.
About This Procedure
HCPCS code J2260 was billed by 14 providers across 27K claims, totaling $947K in Medicaid payments from 2018–2024. This code was used for 3K 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
$35.65
Providers Billing
14
National Spending
$947K
Avg/Median Ratio
1.16×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for J2260
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1538147202 | $273K |
| 2 | 1114099488 | $161K |
| 3 | 1902182637 | $156K |
| 4 | 1255336517 | $87K |
| 5 | 1184709909 | $68K |
| 6 | 1568474716 | $61K |
| 7 | 1750686432 | $56K |
| 8 | 1124579024 | $34K |
| 9 | 1215437553 | $31K |
| 10 | 1538550983 | $8K |
| 11 | 1962468181 | $5K |
| 12 | 1861727588 | $4K |
| 13 | 1518036458 | $3K |
| 14 | Indiana University Health, Inc Indianapolis, IN · Durable Medical Equipment & Medical Supplies | $1K |
Showing top 14 of 14 providers billing this code