Statistical flags indicate unusual patterns — not proof of fraud or wrongdoing. Read our methodology

#4570 of 11K

J2272

HCPCS Procedure Code

HCPCS code J2272 is the #4,570 most-billed Medicaid procedure code, with $509K in payments across 273K claims from 2018–2024. The national median cost per claim is $0.98. Costs vary widely — the 90th percentile is $7.45 per claim, 7.6× the median.

Total Paid

$509K

0.00% of all spending

Total Claims

273K

Providers

595

Avg Cost/Claim

$2

National Cost Distribution

How much do providers bill per claim for J2272? Based on 422 providers billing this code nationally.

Median

$0.98

Average

$2.81

Std Dev

$5.38

Max

$57.43

Percentile Distribution (Cost per Claim)

p10
$0.05
p25
$0.29
Median
$0.98
p75
$2.58
p90
$7.45
p95
$13.09
p99
$22.74

50% of providers bill between $0.29 and $2.58 per claim for this code.

90% bill between $0.05 and $7.45.

Top 1% bill above $22.74.

About This Procedure

HCPCS code J2272 was billed by 595 providers across 273K claims, totaling $509K in Medicaid payments from 2018–2024. This code was used for 215K 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

$0.98

Providers Billing

422

National Spending

$509K

Avg/Median Ratio

2.87×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for J2272

#ProviderTotal Paid
1Texas Children's Hospital

Houston, TX · General Acute Care Hospital Children

$118K
2Pikeville Medical Center Inc

Pikeville, KY · General Acute Care Hospital

$27K
31548393127$15K
41467459776$11K
51306991211$9K
61265539498$9K
71417901091$9K
81124098421$8K
91689282147$8K
101942247291$7K
111033716147$7K
121447231956$6K
131649726738$6K
141013981554$6K
15Montefiore Medical Center

Bronx, NY · General Acute Care Hospital

$6K
161356496772$6K
17Scottish Rite Children's Medical Center

Atlanta, GA · Pediatrics Pediatric Hematology-Oncology

$5K
181962442012$5K
191003985755$5K
201801852835$5K

Showing top 20 of 595 providers billing this code