J9055
HCPCS Procedure Code
HCPCS code J9055 is the #2,604 most-billed Medicaid procedure code, with $4.6M in payments across 633 claims from 2018–2024. The national median cost per claim is $6,494.38.
Total Paid
$4.6M
0.00% of all spending
Total Claims
633
Providers
3
Avg Cost/Claim
$7K
National Cost Distribution
How much do providers bill per claim for J9055? Based on 3 providers billing this code nationally.
Median
$6,494.38
Average
$4,779.25
Std Dev
$4,191.52
Max
$7,841.21
Percentile Distribution (Cost per Claim)
50% of providers bill between $3,248.28 and $7,167.80 per claim for this code.
90% bill between $1,300.61 and $7,571.84.
Top 1% bill above $7,814.27.
About This Procedure
HCPCS code J9055 was billed by 3 providers across 633 claims, totaling $4.6M in Medicaid payments from 2018–2024. This code was used for 382 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
$6,494.38
Providers Billing
3
National Spending
$4.6M
Avg/Median Ratio
0.74×
Normal distribution
Provider Coverage
We have 3 providers billing this code in our dataset. Individual provider breakdowns are available for top-spending procedure codes.