J7297
HCPCS Procedure Code
HCPCS code J7297 is the #2,188 most-billed Medicaid procedure code, with $8.1M in payments across 19K claims from 2018–2024. The national median cost per claim is $569.39.
Total Paid
$8.1M
0.00% of all spending
Total Claims
19K
Providers
102
Avg Cost/Claim
$420
National Cost Distribution
How much do providers bill per claim for J7297? Based on 97 providers billing this code nationally.
Median
$569.39
Average
$498.22
Std Dev
$299.33
Max
$1,178.73
Percentile Distribution (Cost per Claim)
50% of providers bill between $179.12 and $752.00 per claim for this code.
90% bill between $84.77 and $837.76.
Top 1% bill above $1,046.60.
About This Procedure
HCPCS code J7297 was billed by 102 providers across 19K claims, totaling $8.1M in Medicaid payments from 2018–2024. This code was used for 18K 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
$569.39
Providers Billing
97
National Spending
$8.1M
Avg/Median Ratio
0.88×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for J7297
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1417959701 | $969K |
| 2 | 1821095779 | $883K |
| 3 | 1568653780 | $611K |
| 4 | Spectrum Health Primary Care Partners Grand Rapids, MI · Psychologist, Clinical Child & Adolescent | $608K |
| 5 | 1629057146 | $602K |
| 6 | The Metrohealth System Cleveland, OH · General Acute Care Hospital | $574K |
| 7 | Boston Medical Center Corporation Boston, MA · General Acute Care Hospital | $426K |
| 8 | The New York And Presbyterian Hospital New York, NY · General Acute Care Hospital | $263K |
| 9 | Spectrum Health Hospitals Grand Rapids, MI · General Acute Care Hospital | $200K |
| 10 | 1003280546 | $163K |
| 11 | West Virginia University Medical Corporation Morgantown, WV · Anesthesiology | $146K |
| 12 | Baystate Medical Center Inc Springfield, MA · General Acute Care Hospital | $141K |
| 13 | Women & Infants Hospital Of Rhode Island Providence, RI · Clinic/Center, Ambulatory Family Planning Facility | $134K |
| 14 | 1114264660 | $128K |
| 15 | Ohio State University Hospitals Columbus, OH · General Acute Care Hospital | $117K |
| 16 | 1306909957 | $116K |
| 17 | 1285701672 | $96K |
| 18 | 1952490328 | $95K |
| 19 | 1720581432 | $94K |
| 20 | 1477549756 | $88K |
Showing top 20 of 102 providers billing this code