J9209
HCPCS Procedure Code
HCPCS code J9209 is the #7,865 most-billed Medicaid procedure code, with $9K in payments across 403 claims from 2018–2024. The national median cost per claim is $20.31.
Total Paid
$9K
0.00% of all spending
Total Claims
403
Providers
3
Avg Cost/Claim
$22
National Cost Distribution
How much do providers bill per claim for J9209? Based on 2 providers billing this code nationally.
Median
$20.31
Average
$20.31
Std Dev
$26.37
Max
$38.96
Percentile Distribution (Cost per Claim)
50% of providers bill between $10.99 and $29.64 per claim for this code.
90% bill between $5.39 and $35.23.
Top 1% bill above $38.59.
About This Procedure
HCPCS code J9209 was billed by 3 providers across 403 claims, totaling $9K in Medicaid payments from 2018–2024. This code was used for 130 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
$20.31
Providers Billing
2
National Spending
$9K
Avg/Median Ratio
1.00×
Normal distribution
Provider Coverage
We have 2 providers billing this code in our dataset. Individual provider breakdowns are available for top-spending procedure codes.