J9173
Injection, durvalumab, ten milligrams
Injection, durvalumab, ten milligrams is the #1,944 most-billed Medicaid procedure code, with $11.2M in payments across 3K claims from 2018–2024. The national median cost per claim is $3,405.75. Costs vary widely — the 90th percentile is $8,845.23 per claim, 2.6× the median.
Total Paid
$11.2M
0.00% of all spending
Total Claims
3K
Providers
18
Avg Cost/Claim
$4K
National Cost Distribution
How much do providers bill per claim for J9173? Based on 18 providers billing this code nationally.
Median
$3,405.75
Average
$4,402.95
Std Dev
$3,034.35
Max
$10,394.23
Percentile Distribution (Cost per Claim)
50% of providers bill between $2,276.64 and $5,999.37 per claim for this code.
90% bill between $1,020.85 and $8,845.23.
Top 1% bill above $10,289.96.
About This Procedure
HCPCS code J9173 (Injection, durvalumab, ten milligrams) was billed by 18 providers across 3K claims, totaling $11.2M in Medicaid payments from 2018–2024. This code was used for 2K 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
$3,405.75
Providers Billing
18
National Spending
$11.2M
Avg/Median Ratio
1.29×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for J9173
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1528018389 | $2.1M |
| 2 | Yale New Haven Hospital New Haven, CT · General Acute Care Hospital | $2.0M |
| 3 | The Good Samaritan Hospital Of Cincinnati, Ohio Cincinnati, OH · General Acute Care Hospital | $1.5M |
| 4 | 1295023547 | $1.2M |
| 5 | Upmc Magee-womens Hospital Pittsburgh, PA · General Acute Care Hospital | $973K |
| 6 | The Cleveland Clinic Foundation Cleveland, OH · General Acute Care Hospital | $625K |
| 7 | City Of Hope National Medical Center Duarte, CA · General Acute Care Hospital | $513K |
| 8 | Arthur G James Cancer Hospital And Research Institute Columbus, OH · Special Hospital | $489K |
| 9 | Norton Hospitals, Inc Louisville, KY · General Acute Care Hospital | $476K |
| 10 | The Metrohealth System Cleveland, OH · General Acute Care Hospital | $317K |
| 11 | Regents Of The University Of California San Diego, CA · General Acute Care Hospital | $309K |
| 12 | University Hospitals Cleveland Medical Center Cleveland, OH · General Acute Care Hospital | $194K |
| 13 | Memorial Hospital For Cancer And Allied Diseases New York, NY · Pharmacy | $179K |
| 14 | Mount Sinai Hospital New York, NY · Ambulance | $137K |
| 15 | Dayton Osteopathic Hospital Dayton, OH · General Acute Care Hospital | $83K |
| 16 | Norton Hospitals Inc Louisville, KY · General Acute Care Hospital | $59K |
| 17 | Dana-farber Cancer Institute, Inc. Boston, MA · General Acute Care Hospital | $33K |
| 18 | Aurora Health Care Metro, Inc. Milwaukee, WI · Internal Medicine, Hematology & Oncology | $8K |
Showing top 18 of 18 providers billing this code