J7205
HCPCS Procedure Code
HCPCS code J7205 is the #2,585 most-billed Medicaid procedure code, with $4.8M in payments across 1K claims from 2018–2024. The national median cost per claim is $3,514.37.
Total Paid
$4.8M
0.00% of all spending
Total Claims
1K
Providers
1
Avg Cost/Claim
$4K
National Cost Distribution
How much do providers bill per claim for J7205? Based on 1 providers billing this code nationally.
Median
$3,514.37
Average
$3,514.37
Std Dev
—
Max
$3,514.37
Percentile Distribution (Cost per Claim)
50% of providers bill between $3,514.37 and $3,514.37 per claim for this code.
90% bill between $3,514.37 and $3,514.37.
Top 1% bill above $3,514.37.
About This Procedure
HCPCS code J7205 was billed by 1 providers across 1K claims, totaling $4.8M in Medicaid payments from 2018–2024. This code was used for 103 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
$3,514.37
Providers Billing
1
National Spending
$4.8M
Avg/Median Ratio
1.00×
Normal distribution
Provider Coverage
We have 1 providers billing this code in our dataset. Individual provider breakdowns are available for top-spending procedure codes.