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

#7306 of 11K

J2720

HCPCS Procedure Code

HCPCS code J2720 is the #7,306 most-billed Medicaid procedure code, with $22K in payments across 5K claims from 2018–2024. The national median cost per claim is $1.57. Costs vary widely — the 90th percentile is $12.52 per claim, 8.0× the median.

Total Paid

$22K

0.00% of all spending

Total Claims

5K

Providers

53

Avg Cost/Claim

$4

National Cost Distribution

How much do providers bill per claim for J2720? Based on 25 providers billing this code nationally.

Median

$1.57

Average

$4.22

Std Dev

$5.63

Max

$19.84

Percentile Distribution (Cost per Claim)

p10
$0.07
p25
$0.60
Median
$1.57
p75
$5.94
p90
$12.52
p95
$17.21
p99
$19.31

50% of providers bill between $0.60 and $5.94 per claim for this code.

90% bill between $0.07 and $12.52.

Top 1% bill above $19.31.

About This Procedure

HCPCS code J2720 was billed by 53 providers across 5K claims, totaling $22K in Medicaid payments from 2018–2024. This code was used for 4K 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

$1.57

Providers Billing

25

National Spending

$22K

Avg/Median Ratio

2.69×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for J2720

#ProviderTotal Paid
1Seventh-day Adventists Loma Linda University Medical Center

Loma Linda, CA · General Acute Care Hospital

$11K
2Nyu Langone Hospitals

New York, NY · Clinic/Center, Oncology

$4K
31558575746$2K
41740488386$972
51417952748$852
61891938122$798
7Providence Health & Services Washington

Anchorage, AK · General Acute Care Hospital

$626
81427055821$421
9Montefiore Medical Center

Bronx, NY · General Acute Care Hospital

$286
10The Cleveland Clinic Foundation

Cleveland, OH · General Acute Care Hospital

$227
11Mainehealth

Portland, ME · Emergency Medicine

$178
121447415104$129
131538244918$113
141235134024$100
15Community Hospital Of San Bernardino

San Bernardino, CA · General Acute Care Hospital

$76
16Unm Hospital

Albuquerque, NM · General Acute Care Hospital

$64
17University Of Kentucky

Lexington, KY · General Acute Care Hospital

$31
181306914213$20
19Ohio State University Hospitals

Columbus, OH · General Acute Care Hospital

$18
20Bethesda Hospital Inc

Cincinnati, OH · General Acute Care Hospital

$15

Showing top 20 of 53 providers billing this code

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