J9206
HCPCS Procedure Code
HCPCS code J9206 is the #3,541 most-billed Medicaid procedure code, with $1.5M in payments across 49K claims from 2018–2024. The national median cost per claim is $23.69. Costs vary widely — the 90th percentile is $59.19 per claim, 2.5× the median.
Total Paid
$1.5M
0.00% of all spending
Total Claims
49K
Providers
67
Avg Cost/Claim
$31
National Cost Distribution
How much do providers bill per claim for J9206? Based on 52 providers billing this code nationally.
Median
$23.69
Average
$37.84
Std Dev
$69.07
Max
$499.29
Percentile Distribution (Cost per Claim)
50% of providers bill between $10.77 and $40.01 per claim for this code.
90% bill between $4.40 and $59.19.
Top 1% bill above $296.76.
About This Procedure
HCPCS code J9206 was billed by 67 providers across 49K claims, totaling $1.5M in Medicaid payments from 2018–2024. This code was used for 22K 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
$23.69
Providers Billing
52
National Spending
$1.5M
Avg/Median Ratio
1.60×
Moderately skewed
Top Providers Billing This Code
Ranked by total Medicaid payments for J9206
| # | Provider | Total Paid |
|---|---|---|
| 1 | Memorial Hospital For Cancer And Allied Diseases New York, NY · Pharmacy | $406K |
| 2 | Dana-farber Cancer Institute, Inc. Boston, MA · General Acute Care Hospital | $227K |
| 3 | 1164493847 | $116K |
| 4 | Alivia Specialty Llc Guaynabo, PR · Pharmacy Specialty Pharmacy | $92K |
| 5 | Swedish Health Services Seattle, WA · General Acute Care Hospital | $78K |
| 6 | Long Island Jewish Medical Center New Hyde Park, NY · General Acute Care Hospital | $77K |
| 7 | Regents Of The University Of California San Diego, CA · General Acute Care Hospital | $68K |
| 8 | City Of Hope National Medical Center Duarte, CA · General Acute Care Hospital | $61K |
| 9 | 1003989831 | $57K |
| 10 | 1528018389 | $51K |
| 11 | Arthur G James Cancer Hospital And Research Institute Columbus, OH · Special Hospital | $47K |
| 12 | The Cooper Health System Camden, NJ · General Acute Care Hospital | $29K |
| 13 | Montefiore Medical Center Bronx, NY · General Acute Care Hospital | $21K |
| 14 | Multicare Health System Tacoma, WA · Community/Behavioral Health | $17K |
| 15 | University Of California Irvine Orange, CA · General Acute Care Hospital | $16K |
| 16 | Hmh Hospitals Corporation Hackensack, NJ · Ambulance | $14K |
| 17 | 1225033020 | $14K |
| 18 | The New York And Presbyterian Hospital New York, NY · General Acute Care Hospital | $11K |
| 19 | The Cleveland Clinic Foundation Cleveland, OH · General Acute Care Hospital | $11K |
| 20 | 1437230034 | $11K |
Showing top 20 of 67 providers billing this code