#1604 of 11K

J9022

HCPCS Procedure Code

HCPCS code J9022 is the #1,604 most-billed Medicaid procedure code, with $17.9M in payments across 4K claims from 2018–2024. The national median cost per claim is $3,962.67. Costs vary widely — the 90th percentile is $9,351.71 per claim, 2.4× the median.

Total Paid

$17.9M

0.00% of all spending

Total Claims

Providers

Avg Cost/Claim

$4K

National Cost Distribution

How much do providers bill per claim for J9022? Based on 22 providers billing this code nationally.

Median

$3,962.67

Average

$4,874.91

Std Dev

$3,074.35

Max

$11,834.39

Percentile Distribution (Cost per Claim)

p10

$1,159.52

p25

$2,751.95

Median

$3,962.67

p75

$6,342.99

p90

$9,351.71

p95

$9,888.24

p99

$11,431.13

50% of providers bill between $2,751.95 and $6,342.99 per claim for this code.

90% bill between $1,159.52 and $9,351.71.

Top 1% bill above $11,431.13.

About This Procedure

HCPCS code J9022 was billed by 23 providers across 4K claims, totaling $17.9M in Medicaid payments from 2018–2024. This code was used for 3K 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

$3,962.67

Providers Billing

National Spending

$17.9M

Avg/Median Ratio

1.23×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for J9022

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	Alivia Specialty Llc Guaynabo, PR · Pharmacy Specialty Pharmacy	$5.4M	$9,914.12	2.5× median	Top 10%
2	Yale New Haven Hospital New Haven, CT · General Acute Care Hospital	$4.0M	$3,005.31	0.8× median	Below Median
3	1295023547	$1.4M	$6,986.19	1.8× median	Above 75th
4	Regents Of The University Of California San Diego, CA · General Acute Care Hospital	$1.4M	$4,271.92	1.1× median	Above Median
5	1003989831	$992K	$6,276.02	1.6× median	Above Median
6	Upmc Magee-womens Hospital Pittsburgh, PA · General Acute Care Hospital	$654K	$767.16	0.2× median	Below Median
7	1164493847	$510K	$8,949.13	2.3× median	Above 75th
8	Arthur G James Cancer Hospital And Research Institute Columbus, OH · Special Hospital	$462K	$11,834.39	3.0× median	Top 1%
9	The Cleveland Clinic Foundation Cleveland, OH · General Acute Care Hospital	$429K	$5,642.86	1.4× median	Above Median
10	Keck Medical Center Of Usc Los Angeles, CA · General Acute Care Hospital	$413K	$3,687.33	0.9× median	Below Median
11	University Hospitals Cleveland Medical Center Cleveland, OH · General Acute Care Hospital	$338K	$6,136.48	1.5× median	Above Median
12	Temple University Hospital Inc Philadelphia, PA · General Acute Care Hospital	$321K	$2,359.38	0.6× median	Below Median
13	Mount Sinai Hospital New York, NY · Ambulance	$282K	$9,396.44	2.4× median	Top 10%
14	Regents Of The University Of Michigan Ann Arbor, MI · Clinic/Center, End-Stage Renal Disease (ESRD) Treatment	$259K	$3,273.60	0.8× median	Below Median
15	Dana-farber Cancer Institute, Inc. Boston, MA · General Acute Care Hospital	$229K	$6,365.31	1.6× median	Above 75th
16	Norton Hospitals Inc Louisville, KY · General Acute Care Hospital	$216K	$4,073.67	1.0× median	Above Median
17	Henry Ford Health System Detroit, MI · General Acute Care Hospital	$187K	$3,662.77	0.9× median	Below Median
18	Aurora Health Care Metro, Inc. Milwaukee, WI · Internal Medicine, Hematology & Oncology	$122K	$1,045.82	0.3× median	Below Median
19	1083661607	$121K	$898.19	0.2× median	Below Median
20	The Metrohealth System Cleveland, OH · General Acute Care Hospital	$104K	$3,851.66	1.0× median	Below Median

Showing top 20 of 23 providers billing this code

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