J9070
HCPCS Procedure Code
HCPCS code J9070 is the #2,129 most-billed Medicaid procedure code, with $8.7M in payments across 44K claims from 2018–2024. The national median cost per claim is $163.22. Costs vary widely — the 90th percentile is $426.20 per claim, 2.6× the median.
Total Paid
$8.7M
0.00% of all spending
Total Claims
44K
Providers
87
Avg Cost/Claim
$195
National Cost Distribution
How much do providers bill per claim for J9070? Based on 85 providers billing this code nationally.
Median
$163.22
Average
$244.70
Std Dev
$386.30
Max
$3,414.90
Percentile Distribution (Cost per Claim)
50% of providers bill between $87.37 and $301.94 per claim for this code.
90% bill between $25.49 and $426.20.
Top 1% bill above $1,279.01.
About This Procedure
HCPCS code J9070 was billed by 87 providers across 44K claims, totaling $8.7M in Medicaid payments from 2018–2024. This code was used for 21K 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
$163.22
Providers Billing
85
National Spending
$8.7M
Avg/Median Ratio
1.50×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for J9070
| # | Provider | Total Paid |
|---|---|---|
| 1 | Yale New Haven Hospital New Haven, CT · General Acute Care Hospital | $758K |
| 2 | Dana-farber Cancer Institute, Inc. Boston, MA · General Acute Care Hospital | $652K |
| 3 | 1003989831 | $629K |
| 4 | Alivia Specialty Llc Guaynabo, PR · Pharmacy Specialty Pharmacy | $517K |
| 5 | 1447539374 | $465K |
| 6 | Phoenix Children's Hospital Phoenix, AZ · General Acute Care Hospital Children | $437K |
| 7 | Montefiore Medical Center Bronx, NY · General Acute Care Hospital | $291K |
| 8 | Long Island Jewish Medical Center New Hyde Park, NY · General Acute Care Hospital | $270K |
| 9 | Memorial Hospital For Cancer And Allied Diseases New York, NY · Pharmacy | $248K |
| 10 | Banner - University Medical Center Tucson Campus Llc Tucson, AZ · Clinic/Center, Multi-Specialty | $236K |
| 11 | 1437230034 | $236K |
| 12 | The New York And Presbyterian Hospital New York, NY · General Acute Care Hospital | $211K |
| 13 | The General Hospital Corporation Boston, MA · General Acute Care Hospital | $205K |
| 14 | Best Option Healthcare Puerto Rico Llc San Juan, PR · Pharmacy Home Infusion Therapy Pharmacy | $197K |
| 15 | City Of Hope National Medical Center Duarte, CA · General Acute Care Hospital | $190K |
| 16 | Arthur G James Cancer Hospital And Research Institute Columbus, OH · Special Hospital | $190K |
| 17 | 1316900277 | $189K |
| 18 | Regents Of The University Of California San Diego, CA · General Acute Care Hospital | $187K |
| 19 | State Of Mississippi - University Of Mississippi Medical Center Jackson, MS · General Acute Care Hospital | $168K |
| 20 | Regents Of The University Of Michigan Ann Arbor, MI · Clinic/Center, End-Stage Renal Disease (ESRD) Treatment | $163K |
Showing top 20 of 87 providers billing this code