J2920
HCPCS Procedure Code
HCPCS code J2920 is the #4,088 most-billed Medicaid procedure code, with $862K in payments across 204K claims from 2018–2024. The national median cost per claim is $2.93. Costs vary widely — the 90th percentile is $11.20 per claim, 3.8× the median.
Total Paid
$862K
0.00% of all spending
Total Claims
204K
Providers
610
Avg Cost/Claim
$4
National Cost Distribution
How much do providers bill per claim for J2920? Based on 463 providers billing this code nationally.
Median
$2.93
Average
$6.40
Std Dev
$23.16
Max
$424.69
Percentile Distribution (Cost per Claim)
50% of providers bill between $0.95 and $5.06 per claim for this code.
90% bill between $0.15 and $11.20.
Top 1% bill above $60.57.
About This Procedure
HCPCS code J2920 was billed by 610 providers across 204K claims, totaling $862K in Medicaid payments from 2018–2024. This code was used for 137K 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
$2.93
Providers Billing
463
National Spending
$862K
Avg/Median Ratio
2.18×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for J2920
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1457640245 | $61K |
| 2 | 1750332565 | $48K |
| 3 | Rhode Island Hospital Providence, RI · General Acute Care Hospital | $44K |
| 4 | 1811080526 | $34K |
| 5 | 1649270257 | $33K |
| 6 | Seventh-day Adventists Loma Linda University Medical Center Loma Linda, CA · General Acute Care Hospital | $33K |
| 7 | Pikeville Medical Center Inc Pikeville, KY · General Acute Care Hospital | $24K |
| 8 | Uofl Health-louisville Inc Louisville, KY · Psychiatric Hospital | $23K |
| 9 | 1144274317 | $23K |
| 10 | 1639172372 | $22K |
| 11 | Palomar Health Escondido, CA · General Acute Care Hospital | $21K |
| 12 | 1467546135 | $18K |
| 13 | Regents Of The University Of California San Diego, CA · General Acute Care Hospital | $16K |
| 14 | Upmc Children's Hospital Of Pittsburgh Pittsburgh, PA · Clinic/Center | $14K |
| 15 | 1609869916 | $13K |
| 16 | 1780107888 | $12K |
| 17 | 1073518007 | $11K |
| 18 | 1740362755 | $11K |
| 19 | 1184606600 | $10K |
| 20 | Unm Hospital Albuquerque, NM · General Acute Care Hospital | $8K |
Showing top 20 of 610 providers billing this code