J9228
HCPCS Procedure Code
HCPCS code J9228 is the #5,017 most-billed Medicaid procedure code, with $320K in payments across 56 claims from 2018–2024. The national median cost per claim is $5,796.87.
Total Paid
$320K
0.00% of all spending
Total Claims
56
Providers
2
Avg Cost/Claim
$6K
National Cost Distribution
How much do providers bill per claim for J9228? Based on 2 providers billing this code nationally.
Median
$5,796.87
Average
$5,796.87
Std Dev
$1,649.32
Max
$6,963.12
Percentile Distribution (Cost per Claim)
50% of providers bill between $5,213.75 and $6,379.99 per claim for this code.
90% bill between $4,863.87 and $6,729.87.
Top 1% bill above $6,939.79.
About This Procedure
HCPCS code J9228 was billed by 2 providers across 56 claims, totaling $320K in Medicaid payments from 2018–2024. This code was used for 26 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
$5,796.87
Providers Billing
2
National Spending
$320K
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.