Statistical flags indicate unusual patterns — not proof of fraud or wrongdoing. Read our methodology

#6285 of 11K

J7500

HCPCS Procedure Code

HCPCS code J7500 is the #6,285 most-billed Medicaid procedure code, with $78K in payments across 4K claims from 2018–2024. The national median cost per claim is $4.92. Costs vary widely — the 90th percentile is $32.57 per claim, 6.6× the median.

Total Paid

$78K

0.00% of all spending

Total Claims

4K

Providers

13

Avg Cost/Claim

$19

National Cost Distribution

How much do providers bill per claim for J7500? Based on 13 providers billing this code nationally.

Median

$4.92

Average

$18.19

Std Dev

$23.48

Max

$84.57

Percentile Distribution (Cost per Claim)

p10
$0.32
p25
$3.96
Median
$4.92
p75
$25.85
p90
$32.57
p95
$53.55
p99
$78.37

50% of providers bill between $3.96 and $25.85 per claim for this code.

90% bill between $0.32 and $32.57.

Top 1% bill above $78.37.

About This Procedure

HCPCS code J7500 was billed by 13 providers across 4K claims, totaling $78K in Medicaid payments from 2018–2024. This code was used for 4K 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

$4.92

Providers Billing

13

National Spending

$78K

Avg/Median Ratio

3.70×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for J7500

#ProviderTotal Paid
11417901646$55K
21710184106$6K
31225482490$6K
41821329731$5K
51396128864$2K
61285091330$1K
71437253168$854
81679971485$353
91215365325$202
101932135068$143
111770713224$96
121558470039$17
131346263340$6

Showing top 13 of 13 providers billing this code