J2426
HCPCS Procedure Code
HCPCS code J2426 is the #816 most-billed Medicaid procedure code, with $73.8M in payments across 122K claims from 2018–2024. The national median cost per claim is $625.59. Costs vary widely — the 90th percentile is $2,144.04 per claim, 3.4× the median.
Total Paid
$73.8M
0.01% of all spending
Total Claims
122K
Providers
159
Avg Cost/Claim
$605
National Cost Distribution
How much do providers bill per claim for J2426? Based on 121 providers billing this code nationally.
Median
$625.59
Average
$858.41
Std Dev
$981.38
Max
$5,401.76
Percentile Distribution (Cost per Claim)
50% of providers bill between $6.23 and $1,397.66 per claim for this code.
90% bill between $0.01 and $2,144.04.
Top 1% bill above $3,953.16.
About This Procedure
HCPCS code J2426 was billed by 159 providers across 122K claims, totaling $73.8M in Medicaid payments from 2018–2024. This code was used for 106K 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
$625.59
Providers Billing
121
National Spending
$73.8M
Avg/Median Ratio
1.37×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for J2426
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1053358945 | $10.4M |
| 2 | Jefferson Center For Mental Health Wheat Ridge, CO · Clinic/Center Mental Health (Including Community Mental Health Center) | $7.0M |
| 3 | 1174693592 | $6.5M |
| 4 | Jersey City Medical Center Jersey City, NJ · General Acute Care Hospital | $5.7M |
| 5 | St Lukes Roosevelt Hospital Center New York, NY · Case Management | $2.8M |
| 6 | Bronxcare Health System Bronx, NY · General Acute Care Hospital | $2.7M |
| 7 | 1336366822 | $2.4M |
| 8 | Rochester General Hospital Rochester, NY · Dentist, General Practice | $2.4M |
| 9 | University Of Rochester Rochester, NY · General Acute Care Hospital | $2.3M |
| 10 | 1053314021 | $2.2M |
| 11 | Tarrant County Hospital District Fort Worth, TX · Clinic/Center, Ambulatory Family Planning Facility | $1.9M |
| 12 | Beth Israel Medical Center Brooklyn, NY · Psychiatric Unit | $1.7M |
| 13 | New York City Health And Hospitals Corporation Jamaica, NY · General Acute Care Hospital | $1.3M |
| 14 | New York City Health And Hospitals Corporation Brooklyn, NY · Internal Medicine | $1.3M |
| 15 | Permanente Medical Group Inc Stockton, CA · Anesthesiology | $1.3M |
| 16 | 1417934175 | $1.2M |
| 17 | Procare Pharmacy Direct, Llc. Monroeville, PA · Pharmacy, Community/Retail Pharmacy | $1.2M |
| 18 | Not Found Unknown, Unknown · Unknown | $1.2M |
| 19 | 1154433233 | $1.1M |
| 20 | New York City Health And Hospitals Corporation New York, NY · Internal Medicine | $980K |
Showing top 20 of 159 providers billing this code