J9045
HCPCS Procedure Code
HCPCS code J9045 is the #2,753 most-billed Medicaid procedure code, with $3.8M in payments across 175K claims from 2018–2024. The national median cost per claim is $14.63. Costs vary widely — the 90th percentile is $60.36 per claim, 4.1× the median.
Total Paid
$3.8M
0.00% of all spending
Total Claims
175K
Providers
238
Avg Cost/Claim
$22
National Cost Distribution
How much do providers bill per claim for J9045? Based on 192 providers billing this code nationally.
Median
$14.63
Average
$36.02
Std Dev
$100.65
Max
$970.78
Percentile Distribution (Cost per Claim)
50% of providers bill between $6.88 and $30.20 per claim for this code.
90% bill between $2.41 and $60.36.
Top 1% bill above $530.52.
About This Procedure
HCPCS code J9045 was billed by 238 providers across 175K claims, totaling $3.8M in Medicaid payments from 2018–2024. This code was used for 103K 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
$14.63
Providers Billing
192
National Spending
$3.8M
Avg/Median Ratio
2.46×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for J9045
| # | Provider | Total Paid |
|---|---|---|
| 1 | Robert Wood Johnson University Hospital, Inc New Brunswick, NJ · General Acute Care Hospital | $560K |
| 2 | Englewood Hospital And Medical Center Englewood, NJ · General Acute Care Hospital | $290K |
| 3 | Rhode Island Hospital Providence, RI · General Acute Care Hospital | $245K |
| 4 | Memorial Hospital For Cancer And Allied Diseases New York, NY · Pharmacy | $201K |
| 5 | University Hospital Newark, NJ · General Acute Care Hospital | $170K |
| 6 | Regents Of The University Of California San Diego, CA · General Acute Care Hospital | $93K |
| 7 | University Of Kentucky Lexington, KY · General Acute Care Hospital | $92K |
| 8 | 1003989831 | $87K |
| 9 | Stanford Health Care Stanford, CA · General Acute Care Hospital | $87K |
| 10 | Long Island Jewish Medical Center New Hyde Park, NY · General Acute Care Hospital | $86K |
| 11 | Alivia Specialty Llc Guaynabo, PR · Pharmacy Specialty Pharmacy | $84K |
| 12 | The Cooper Health System Camden, NJ · General Acute Care Hospital | $75K |
| 13 | Seventh-day Adventists Loma Linda University Medical Center Loma Linda, CA · General Acute Care Hospital | $68K |
| 14 | 1548315401 | $67K |
| 15 | 1679660617 | $67K |
| 16 | 1477549756 | $63K |
| 17 | Arthur G James Cancer Hospital And Research Institute Columbus, OH · Special Hospital | $63K |
| 18 | City Of Hope National Medical Center Duarte, CA · General Acute Care Hospital | $57K |
| 19 | University Of California Irvine Orange, CA · General Acute Care Hospital | $52K |
| 20 | Norton Hospitals Inc Louisville, KY · General Acute Care Hospital | $51K |
Showing top 20 of 238 providers billing this code