#2578 of 11K

J7303

HCPCS Procedure Code

HCPCS code J7303 is the #2,578 most-billed Medicaid procedure code, with $4.9M in payments across 32K claims from 2018–2024. The national median cost per claim is $125.58. Costs vary widely — the 90th percentile is $336.58 per claim, 2.7× the median.

Total Paid

$4.9M

0.00% of all spending

Total Claims

32K

Providers

112

Avg Cost/Claim

$153

National Cost Distribution

How much do providers bill per claim for J7303? Based on 112 providers billing this code nationally.

Median

$125.58

Average

$193.22

Std Dev

$275.71

Max

$2,130.32

Percentile Distribution (Cost per Claim)

p10

$25.85

p25

$73.66

Median

$125.58

p75

$196.83

p90

$336.58

p95

$527.21

p99

$1,514.19

50% of providers bill between $73.66 and $196.83 per claim for this code.

90% bill between $25.85 and $336.58.

Top 1% bill above $1,514.19.

About This Procedure

HCPCS code J7303 was billed by 112 providers across 32K claims, totaling $4.9M in Medicaid payments from 2018–2024. This code was used for 31K 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

$125.58

Providers Billing

112

National Spending

$4.9M

Avg/Median Ratio

1.54×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for J7303

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1629057146	$1.4M	$310.52	2.5× median	Above 75th
2	Planned Parenthood/orange And San Bernardino Counties, Inc. Orange, CA · Clinic/Center, Ambulatory Family Planning Facility	$641K	$166.27	1.3× median	Above Median
3	1336174325	$428K	$950.32	7.6× median	Top 10%
4	Planned Parenthood Of Wisconsin Milwaukee, WI · Clinic/Center Ambulatory Family Planning Facility	$341K	$65.50	0.5× median	Below Median
5	1588738389	$158K	$1,583.89	12.6× median	Top 1%
6	1366525370	$130K	$91.16	0.7× median	Below Median
7	1538152491	$121K	$171.83	1.4× median	Above Median
8	1982747184	$78K	$48.22	0.4× median	Below Median
9	1508930561	$72K	$121.72	1.0× median	Below Median
10	1174633143	$67K	$64.83	0.5× median	Below Median
11	1982777256	$66K	$2,130.32	17.0× median	Top 1%
12	1184641664	$63K	$647.05	5.2× median	Top 10%
13	1245257708	$59K	$211.22	1.7× median	Above 75th
14	1598719189	$59K	$470.96	3.8× median	Top 10%
15	1053420992	$44K	$149.65	1.2× median	Above Median
16	1215962204	$43K	$152.15	1.2× median	Above Median
17	1366496838	$43K	$320.01	2.5× median	Above 75th
18	1255420436	$42K	$88.65	0.7× median	Below Median
19	1295824498	$39K	$85.43	0.7× median	Below Median
20	1861581043	$38K	$75.33	0.6× median	Below Median

Showing top 20 of 112 providers billing this code

Related Procedures

J7307Etonogestrel implant system, including implant and supplies$192.3M J7298$77.8M J7300$20.8M J7304$19.6M J7297$8.1M

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