J9358
HCPCS Procedure Code
HCPCS code J9358 is the #1,377 most-billed Medicaid procedure code, with $25.2M in payments across 6K claims from 2018–2024. The national median cost per claim is $3,408.30. Costs vary widely — the 90th percentile is $9,002.73 per claim, 2.6× the median.
Total Paid
$25.2M
0.00% of all spending
Total Claims
6K
Providers
15
Avg Cost/Claim
$4K
National Cost Distribution
How much do providers bill per claim for J9358? Based on 14 providers billing this code nationally.
Median
$3,408.30
Average
$4,342.26
Std Dev
$3,022.80
Max
$10,192.80
Percentile Distribution (Cost per Claim)
50% of providers bill between $2,062.98 and $6,258.93 per claim for this code.
90% bill between $1,657.62 and $9,002.73.
Top 1% bill above $10,170.17.
About This Procedure
HCPCS code J9358 was billed by 15 providers across 6K claims, totaling $25.2M in Medicaid payments from 2018–2024. This code was used for 3K 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
$3,408.30
Providers Billing
14
National Spending
$25.2M
Avg/Median Ratio
1.27×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for J9358
| # | Provider | Total Paid |
|---|---|---|
| 1 | Alivia Specialty Llc Guaynabo, PR · Pharmacy Specialty Pharmacy | $7.3M |
| 2 | City Of Hope National Medical Center Duarte, CA · General Acute Care Hospital | $4.8M |
| 3 | Arthur G James Cancer Hospital And Research Institute Columbus, OH · Special Hospital | $4.0M |
| 4 | Dana-farber Cancer Institute, Inc. Boston, MA · General Acute Care Hospital | $3.4M |
| 5 | Memorial Hospital For Cancer And Allied Diseases New York, NY · Pharmacy | $3.3M |
| 6 | Yale New Haven Hospital New Haven, CT · General Acute Care Hospital | $1.0M |
| 7 | 1003989831 | $391K |
| 8 | Regents Of The University Of California San Diego, CA · General Acute Care Hospital | $329K |
| 9 | Hmh Hospitals Corporation Hackensack, NJ · Ambulance | $212K |
| 10 | 1528018389 | $124K |
| 11 | County Of Santa Clara San Jose, CA · Case Manager/Care Coordinator | $67K |
| 12 | 1164493847 | $65K |
| 13 | 1770690695 | $63K |
| 14 | 1679660617 | $56K |
| 15 | Upmc Magee-womens Hospital Pittsburgh, PA · General Acute Care Hospital | $0 |
Showing top 15 of 15 providers billing this code