J2501
HCPCS Procedure Code
HCPCS code J2501 is the #999 most-billed Medicaid procedure code, with $49.2M in payments across 3.4M claims from 2018–2024. The national median cost per claim is $1.13. Costs vary widely — the 90th percentile is $85.61 per claim, 75.8× the median.
Total Paid
$49.2M
0.00% of all spending
Total Claims
3.4M
Providers
417
Avg Cost/Claim
$15
National Cost Distribution
How much do providers bill per claim for J2501? Based on 328 providers billing this code nationally.
Median
$1.13
Average
$23.82
Std Dev
$62.72
Max
$539.35
Percentile Distribution (Cost per Claim)
50% of providers bill between $0.38 and $7.50 per claim for this code.
90% bill between $0.07 and $85.61.
Top 1% bill above $270.65.
About This Procedure
HCPCS code J2501 was billed by 417 providers across 3.4M claims, totaling $49.2M in Medicaid payments from 2018–2024. This code was used for 294K 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
$1.13
Providers Billing
328
National Spending
$49.2M
Avg/Median Ratio
21.08×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for J2501
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1316127921 | $4.1M |
| 2 | 1104844562 | $4.0M |
| 3 | 1083848980 | $3.8M |
| 4 | 1134308489 | $3.1M |
| 5 | 1932176484 | $2.7M |
| 6 | 1942293691 | $2.6M |
| 7 | 1225436199 | $2.4M |
| 8 | 1821520735 | $2.0M |
| 9 | 1326314295 | $1.8M |
| 10 | Central Florida Kidney Centers Inc Orlando, FL · Clinic/Center End-Stage Renal Disease (ESRD) Treatment | $1.7M |
| 11 | 1467807180 | $1.5M |
| 12 | 1710378120 | $1.2M |
| 13 | Mount Sinai Hospital New York, NY · Ambulance | $1.0M |
| 14 | 1104268325 | $857K |
| 15 | 1205140886 | $847K |
| 16 | 1346522679 | $685K |
| 17 | 1174646558 | $673K |
| 18 | 1780874214 | $634K |
| 19 | 1013482215 | $630K |
| 20 | 1578895082 | $627K |
Showing top 20 of 417 providers billing this code