J3473
HCPCS Procedure Code
HCPCS code J3473 is the #5,715 most-billed Medicaid procedure code, with $149K in payments across 7K claims from 2018–2024. The national median cost per claim is $24.87.
Total Paid
$149K
0.00% of all spending
Total Claims
7K
Providers
31
Avg Cost/Claim
$20
National Cost Distribution
How much do providers bill per claim for J3473? Based on 19 providers billing this code nationally.
Median
$24.87
Average
$30.85
Std Dev
$54.42
Max
$247.67
Percentile Distribution (Cost per Claim)
50% of providers bill between $3.73 and $29.84 per claim for this code.
90% bill between $1.13 and $40.75.
Top 1% bill above $211.08.
About This Procedure
HCPCS code J3473 was billed by 31 providers across 7K claims, totaling $149K in Medicaid payments from 2018–2024. This code was used for 6K 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
$24.87
Providers Billing
19
National Spending
$149K
Avg/Median Ratio
1.24×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for J3473
| # | Provider | Total Paid |
|---|---|---|
| 1 | Seventh-day Adventists Loma Linda University Medical Center Loma Linda, CA · General Acute Care Hospital | $62K |
| 2 | 1639101751 | $26K |
| 3 | University Of Kentucky Lexington, KY · General Acute Care Hospital | $23K |
| 4 | 1689744450 | $9K |
| 5 | West Virginia University Hospitals, Inc Morgantown, WV · Clinical Medical Laboratory | $7K |
| 6 | 1245251222 | $6K |
| 7 | Rector & Visitors Of The University Of Virginia Charlottesville, VA · General Acute Care Hospital | $4K |
| 8 | 1306914213 | $4K |
| 9 | 1841397932 | $3K |
| 10 | 1881695146 | $2K |
| 11 | 1356307581 | $761 |
| 12 | Dayton Osteopathic Hospital Dayton, OH · General Acute Care Hospital | $476 |
| 13 | District Hospital Partners L P Washington, DC · Nurse Practitioner, Family | $348 |
| 14 | 1235196510 | $336 |
| 15 | Public Hospital District 1 Of King County Renton, WA · General Acute Care Hospital | $308 |
| 16 | 1043240682 | $136 |
| 17 | University Of Cincinnati Medical Center, Llc Cincinnati, OH · General Acute Care Hospital | $113 |
| 18 | Tufts Medical Center, Inc. Boston, MA · General Acute Care Hospital | $23 |
| 19 | Froedtert Memorial Lutheran Hospital, Inc. Milwaukee, WI · Clinic/Center, Radiology | $3 |
| 20 | Umass Memorial Medical Center, Inc. Worcester, MA · General Acute Care Hospital | $0 |
Showing top 20 of 31 providers billing this code