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

#6254 of 11K

J2400

HCPCS Procedure Code

HCPCS code J2400 is the #6,254 most-billed Medicaid procedure code, with $80K in payments across 4K claims from 2018–2024. The national median cost per claim is $21.05. Costs vary widely — the 90th percentile is $87.09 per claim, 4.1× the median.

Total Paid

$80K

0.00% of all spending

Total Claims

4K

Providers

12

Avg Cost/Claim

$20

National Cost Distribution

How much do providers bill per claim for J2400? Based on 9 providers billing this code nationally.

Median

$21.05

Average

$43.32

Std Dev

$66.59

Max

$216.15

Percentile Distribution (Cost per Claim)

p10
$7.90
p25
$8.17
Median
$21.05
p75
$35.29
p90
$87.09
p95
$151.62
p99
$203.24

50% of providers bill between $8.17 and $35.29 per claim for this code.

90% bill between $7.90 and $87.09.

Top 1% bill above $203.24.

About This Procedure

HCPCS code J2400 was billed by 12 providers across 4K claims, totaling $80K 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

$21.05

Providers Billing

9

National Spending

$80K

Avg/Median Ratio

2.06×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for J2400

#ProviderTotal Paid
1City & County Of San Francisco

San Francisco, CA · Case Manager/Care Coordinator

$29K
21316907322$27K
31295726362$14K
4University Of Colorado Hospital Authority

Aurora, CO · General Acute Care Hospital

$3K
5Unm Hospital

Albuquerque, NM · General Acute Care Hospital

$2K
61134108103$2K
71689987166$2K
8The General Hospital Corporation

Boston, MA · General Acute Care Hospital

$713
91770586794$379
10Henry Ford Health St. John Hospital

Chicago, IL · Clinic/Center, Ambulatory Surgical

$0
111528628633$0
121992394605$0

Showing top 12 of 12 providers billing this code