J2326
Nusinersen (Spinraza), 12 mg intrathecal injection
Nusinersen (Spinraza), 12 mg intrathecal injection is the #615 most-billed Medicaid procedure code, with $124.7M in payments across 1K claims from 2018–2024. The national median cost per claim is $99,695.50.
Total Paid
$124.7M
0.01% of all spending
Total Claims
1K
Providers
3
Avg Cost/Claim
$92K
National Cost Distribution
How much do providers bill per claim for J2326? Based on 3 providers billing this code nationally.
Median
$99,695.50
Average
$105,081.32
Std Dev
$23,341.68
Max
$130,645.14
Percentile Distribution (Cost per Claim)
50% of providers bill between $92,299.41 and $115,170.32 per claim for this code.
90% bill between $87,861.75 and $124,455.21.
Top 1% bill above $130,026.15.
About This Procedure
HCPCS code J2326 (Nusinersen (Spinraza), 12 mg intrathecal injection) was billed by 3 providers across 1K claims, totaling $124.7M in Medicaid payments from 2018–2024. This code was used for 983 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
This procedure is featured in our investigation: Specialty Drug Costs
Read the full analysis for context on billing patterns associated with this code.
Billing Statistics
Median Cost/Claim
$99,695.50
Providers Billing
3
National Spending
$124.7M
Avg/Median Ratio
1.05×
Normal distribution
Provider Coverage
We have 3 providers billing this code in our dataset. Individual provider breakdowns are available for top-spending procedure codes.