J3470
HCPCS Procedure Code
HCPCS code J3470 is the #7,551 most-billed Medicaid procedure code, with $15K in payments across 3K claims from 2018–2024. The national median cost per claim is $5.22. Costs vary widely — the 90th percentile is $32.72 per claim, 6.3× the median.
Total Paid
$15K
0.00% of all spending
Total Claims
3K
Providers
9
Avg Cost/Claim
$5
National Cost Distribution
How much do providers bill per claim for J3470? Based on 6 providers billing this code nationally.
Median
$5.22
Average
$12.96
Std Dev
$19.92
Max
$52.53
Percentile Distribution (Cost per Claim)
50% of providers bill between $1.96 and $11.50 per claim for this code.
90% bill between $0.94 and $32.72.
Top 1% bill above $50.55.
About This Procedure
HCPCS code J3470 was billed by 9 providers across 3K claims, totaling $15K in Medicaid payments from 2018–2024. This code was used for 3K 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
$5.22
Providers Billing
6
National Spending
$15K
Avg/Median Ratio
2.48×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for J3470
| # | Provider | Total Paid |
|---|---|---|
| 1 | The Cleveland Clinic Foundation Cleveland, OH · General Acute Care Hospital | $9K |
| 2 | Virginia Commonwealth University Health System Authority Richmond, VA · General Acute Care Hospital | $4K |
| 3 | Beth Israel Deaconess Medical Center, Inc. Boston, MA · General Acute Care Hospital | $2K |
| 4 | 1538131214 | $298 |
| 5 | 1881695146 | $142 |
| 6 | The Lowell General Hospital Lowell, MA · Pharmacy, Institutional Pharmacy | $9 |
| 7 | 1871859306 | $0 |
| 8 | 1538535158 | $0 |
| 9 | 1043240682 | $0 |
Showing top 9 of 9 providers billing this code