J0137
HCPCS Procedure Code
HCPCS code J0137 is the #6,001 most-billed Medicaid procedure code, with $108K in payments across 31K claims from 2018–2024. The national median cost per claim is $1.48. Costs vary widely — the 90th percentile is $17.72 per claim, 12.0× the median.
Total Paid
$108K
0.00% of all spending
Total Claims
31K
Providers
158
Avg Cost/Claim
$3
National Cost Distribution
How much do providers bill per claim for J0137? Based on 104 providers billing this code nationally.
Median
$1.48
Average
$5.92
Std Dev
$9.54
Max
$45.84
Percentile Distribution (Cost per Claim)
50% of providers bill between $0.34 and $6.79 per claim for this code.
90% bill between $0.07 and $17.72.
Top 1% bill above $35.54.
About This Procedure
HCPCS code J0137 was billed by 158 providers across 31K claims, totaling $108K in Medicaid payments from 2018–2024. This code was used for 26K 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
$1.48
Providers Billing
104
National Spending
$108K
Avg/Median Ratio
4.00×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for J0137
| # | Provider | Total Paid |
|---|---|---|
| 1 | Seventh-day Adventists Loma Linda University Medical Center Loma Linda, CA · General Acute Care Hospital | $23K |
| 2 | Boston Medical Center Corporation Boston, MA · General Acute Care Hospital | $9K |
| 3 | 1356390264 | $9K |
| 4 | 1467808659 | $8K |
| 5 | 1639523004 | $4K |
| 6 | 1174618953 | $4K |
| 7 | 1811946734 | $4K |
| 8 | 1588663769 | $3K |
| 9 | 1194774299 | $3K |
| 10 | The Cooper Health System Camden, NJ · General Acute Care Hospital | $3K |
| 11 | 1699129601 | $2K |
| 12 | The General Hospital Corporation Boston, MA · General Acute Care Hospital | $2K |
| 13 | Pikeville Medical Center Inc Pikeville, KY · General Acute Care Hospital | $2K |
| 14 | Loma Linda University Children's Hospital Loma Linda, CA · General Acute Care Hospital Children | $2K |
| 15 | 1801960513 | $2K |
| 16 | 1427055821 | $2K |
| 17 | University Of Kentucky Lexington, KY · General Acute Care Hospital | $2K |
| 18 | 1982720249 | $2K |
| 19 | 1427616002 | $1K |
| 20 | Owensboro Health Inc Owensboro, KY · General Acute Care Hospital | $1K |
Showing top 20 of 158 providers billing this code