J9355
Injection, trastuzumab, ten milligrams
Injection, trastuzumab, ten milligrams is the #736 most-billed Medicaid procedure code, with $92.4M in payments across 45K claims from 2018–2024. The national median cost per claim is $1,942.13. Costs vary widely — the 90th percentile is $4,414.58 per claim, 2.3× the median.
Total Paid
$92.4M
0.01% of all spending
Total Claims
45K
Providers
79
Avg Cost/Claim
$2K
National Cost Distribution
How much do providers bill per claim for J9355? Based on 75 providers billing this code nationally.
Median
$1,942.13
Average
$2,211.05
Std Dev
$1,510.65
Max
$5,726.04
Percentile Distribution (Cost per Claim)
50% of providers bill between $933.57 and $3,338.52 per claim for this code.
90% bill between $363.61 and $4,414.58.
Top 1% bill above $5,577.91.
About This Procedure
HCPCS code J9355 (Injection, trastuzumab, ten milligrams) was billed by 79 providers across 45K claims, totaling $92.4M in Medicaid payments from 2018–2024. This code was used for 24K 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
$1,942.13
Providers Billing
75
National Spending
$92.4M
Avg/Median Ratio
1.14×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for J9355
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1003989831 | $12.3M |
| 2 | Alivia Specialty Llc Guaynabo, PR · Pharmacy Specialty Pharmacy | $9.4M |
| 3 | Regents Of The University Of California San Diego, CA · General Acute Care Hospital | $5.6M |
| 4 | Dana-farber Cancer Institute, Inc. Boston, MA · General Acute Care Hospital | $5.1M |
| 5 | 1770690695 | $4.1M |
| 6 | Stanford Health Care Stanford, CA · General Acute Care Hospital | $4.0M |
| 7 | Best Option Healthcare Puerto Rico Llc San Juan, PR · Pharmacy Home Infusion Therapy Pharmacy | $3.7M |
| 8 | 1457361271 | $3.2M |
| 9 | Yale New Haven Hospital New Haven, CT · General Acute Care Hospital | $3.0M |
| 10 | Hmh Hospitals Corporation Hackensack, NJ · Ambulance | $2.6M |
| 11 | Long Island Jewish Medical Center New Hyde Park, NY · General Acute Care Hospital | $2.6M |
| 12 | Arthur G James Cancer Hospital And Research Institute Columbus, OH · Special Hospital | $2.4M |
| 13 | City Of Hope National Medical Center Duarte, CA · General Acute Care Hospital | $2.2M |
| 14 | 1164493847 | $2.0M |
| 15 | Seventh-day Adventists Loma Linda University Medical Center Loma Linda, CA · General Acute Care Hospital | $1.9M |
| 16 | The General Hospital Corporation Boston, MA · General Acute Care Hospital | $1.9M |
| 17 | 1558575746 | $1.8M |
| 18 | 1528018389 | $1.7M |
| 19 | 1447539374 | $1.6M |
| 20 | Maimonides Medical Center Brooklyn, NY · General Acute Care Hospital | $1.3M |
Showing top 20 of 79 providers billing this code