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

#2406 of 11K

J9041

HCPCS Procedure Code

HCPCS code J9041 is the #2,406 most-billed Medicaid procedure code, with $6.0M in payments across 28K claims from 2018–2024. The national median cost per claim is $157.53. Costs vary widely — the 90th percentile is $586.36 per claim, 3.7× the median.

Total Paid

$6.0M

0.00% of all spending

Total Claims

28K

Providers

20

Avg Cost/Claim

$219

National Cost Distribution

How much do providers bill per claim for J9041? Based on 19 providers billing this code nationally.

Median

$157.53

Average

$246.95

Std Dev

$223.48

Max

$785.57

Percentile Distribution (Cost per Claim)

p10
$42.40
p25
$100.58
Median
$157.53
p75
$353.48
p90
$586.36
p95
$680.75
p99
$764.61

50% of providers bill between $100.58 and $353.48 per claim for this code.

90% bill between $42.40 and $586.36.

Top 1% bill above $764.61.

About This Procedure

HCPCS code J9041 was billed by 20 providers across 28K claims, totaling $6.0M in Medicaid payments from 2018–2024. This code was used for 6K 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

$157.53

Providers Billing

19

National Spending

$6.0M

Avg/Median Ratio

1.57×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for J9041

#ProviderTotal Paid
1Dana-farber Cancer Institute, Inc.

Boston, MA · General Acute Care Hospital

$2.2M
2Yale New Haven Hospital

New Haven, CT · General Acute Care Hospital

$2.1M
3Montefiore Medical Center

Bronx, NY · General Acute Care Hospital

$644K
4Long Island Jewish Medical Center

New Hyde Park, NY · General Acute Care Hospital

$250K
51164493847$189K
6Boston Medical Center Corporation

Boston, MA · General Acute Care Hospital

$127K
71770690695$108K
8County Of Santa Clara

San Jose, CA · Case Manager/Care Coordinator

$88K
9The Cleveland Clinic Foundation

Cleveland, OH · General Acute Care Hospital

$87K
101477549756$44K
11City Of Hope National Medical Center

Duarte, CA · General Acute Care Hospital

$42K
12The Cooper Health System

Camden, NJ · General Acute Care Hospital

$36K
131699986331$32K
141679660617$31K
15State Of Mississippi - University Of Mississippi Medical Center

Jackson, MS · General Acute Care Hospital

$28K
161295023547$20K
17The General Hospital Corporation

Boston, MA · General Acute Care Hospital

$18K
18Aurora Health Care Metro, Inc.

Milwaukee, WI · Internal Medicine, Hematology & Oncology

$9K
19Froedtert Memorial Lutheran Hospital, Inc.

Milwaukee, WI · Clinic/Center, Radiology

$6K
20Temple University Hospital Inc

Philadelphia, PA · General Acute Care Hospital

$0

Showing top 20 of 20 providers billing this code