J7121
HCPCS Procedure Code
HCPCS code J7121 is the #4,731 most-billed Medicaid procedure code, with $428K in payments across 52K claims from 2018–2024. The national median cost per claim is $1.75. Costs vary widely — the 90th percentile is $33.75 per claim, 19.3× the median.
Total Paid
$428K
0.00% of all spending
Total Claims
52K
Providers
86
Avg Cost/Claim
$8
National Cost Distribution
How much do providers bill per claim for J7121? Based on 55 providers billing this code nationally.
Median
$1.75
Average
$14.14
Std Dev
$38.08
Max
$249.95
Percentile Distribution (Cost per Claim)
50% of providers bill between $0.30 and $7.87 per claim for this code.
90% bill between $0.10 and $33.75.
Top 1% bill above $168.68.
About This Procedure
HCPCS code J7121 was billed by 86 providers across 52K claims, totaling $428K in Medicaid payments from 2018–2024. This code was used for 41K 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
$1.75
Providers Billing
55
National Spending
$428K
Avg/Median Ratio
8.08×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for J7121
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1649726738 | $267K |
| 2 | 1649276734 | $44K |
| 3 | 1043293608 | $41K |
| 4 | Henry Ford Health System Detroit, MI · General Acute Care Hospital | $35K |
| 5 | 1699756221 | $10K |
| 6 | Children's Hospital Medical Center Of Akron Akron, OH · General Acute Care Hospital Children | $8K |
| 7 | 1417952748 | $3K |
| 8 | Scottish Rite Children's Medical Center Atlanta, GA · Pediatrics Pediatric Hematology-Oncology | $2K |
| 9 | Nationwide Children's Hospital Columbus, OH · General Acute Care Hospital | $2K |
| 10 | University Of California Irvine Orange, CA · General Acute Care Hospital | $2K |
| 11 | 1568528594 | $1K |
| 12 | 1730171265 | $1K |
| 13 | Ohiohealth Corporation Columbus, OH · General Acute Care Hospital | $1K |
| 14 | 1437122009 | $1K |
| 15 | 1023086055 | $807 |
| 16 | 1124098421 | $792 |
| 17 | Southern Ohio Medical Center Portsmouth, OH · Clinical Medical Laboratory | $725 |
| 18 | 1619969219 | $679 |
| 19 | 1972557064 | $564 |
| 20 | Pikeville Medical Center Inc Pikeville, KY · General Acute Care Hospital | $527 |
Showing top 20 of 86 providers billing this code