J3316
HCPCS Procedure Code
HCPCS code J3316 is the #1,921 most-billed Medicaid procedure code, with $11.5M in payments across 774 claims from 2018–2024. The national median cost per claim is $14,875.75.
Total Paid
$11.5M
0.00% of all spending
Total Claims
774
Providers
2
Avg Cost/Claim
$15K
National Cost Distribution
How much do providers bill per claim for J3316? Based on 2 providers billing this code nationally.
Median
$14,875.75
Average
$14,875.75
Std Dev
$95.55
Max
$14,943.31
Percentile Distribution (Cost per Claim)
50% of providers bill between $14,841.96 and $14,909.53 per claim for this code.
90% bill between $14,821.69 and $14,929.80.
Top 1% bill above $14,941.96.
About This Procedure
HCPCS code J3316 was billed by 2 providers across 774 claims, totaling $11.5M in Medicaid payments from 2018–2024. This code was used for 649 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
$14,875.75
Providers Billing
2
National Spending
$11.5M
Avg/Median Ratio
1.00×
Normal distribution
Provider Coverage
We have 2 providers billing this code in our dataset. Individual provider breakdowns are available for top-spending procedure codes.