J9040
HCPCS Procedure Code
HCPCS code J9040 is the #8,562 most-billed Medicaid procedure code, with $2K in payments across 99 claims from 2018–2024. The national median cost per claim is $20.14.
Total Paid
$2K
0.00% of all spending
Total Claims
99
Providers
3
Avg Cost/Claim
$22
National Cost Distribution
How much do providers bill per claim for J9040? Based on 3 providers billing this code nationally.
Median
$20.14
Average
$20.36
Std Dev
$10.53
Max
$31.01
Percentile Distribution (Cost per Claim)
50% of providers bill between $15.04 and $25.57 per claim for this code.
90% bill between $11.98 and $28.83.
Top 1% bill above $30.79.
About This Procedure
HCPCS code J9040 was billed by 3 providers across 99 claims, totaling $2K in Medicaid payments from 2018–2024. This code was used for 92 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
$20.14
Providers Billing
3
National Spending
$2K
Avg/Median Ratio
1.01×
Normal distribution
Provider Coverage
We have 3 providers billing this code in our dataset. Individual provider breakdowns are available for top-spending procedure codes.