J0248
HCPCS Procedure Code
HCPCS code J0248 is the #3,673 most-billed Medicaid procedure code, with $1.4M in payments across 5,201 claims from 2018–2024. The national median cost per claim is $229.59. Costs vary widely — the 90th percentile is $530.27 per claim, 2.3× the median.
Total Paid
$1.4M
0.00% of all spending
Total Claims
5,201
Providers
38
Avg Cost/Claim
$260
National Cost Distribution
How much do providers bill per claim for J0248? Based on 38 providers billing this code nationally.
Median
$229.59
Average
$276.29
Std Dev
$208.96
Max
$1,017.78
Percentile Distribution (Cost per Claim)
50% of providers bill between $132.68 and $417.07 per claim for this code.
90% bill between $67.87 and $530.27.
Top 1% bill above $853.89.
About This Procedure
HCPCS code J0248 was billed by 38 providers across 5,201 claims, totaling $1.4M in Medicaid payments from 2018–2024. This code was used for 1,643 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
$229.59
Providers Billing
38
National Spending
$1.4M
Avg/Median Ratio
1.20×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for J0248
| # | Provider | Total Paid |
|---|---|---|
| 1 | Umass Memorial Medical Center, Inc. Worcester, MA · General Acute Care Hospital | $506K |
| 2 | 1366407603 | $90K |
| 3 | Presbyterian Healthcare Services Albuquerque, NM · Emergency Medicine | $78K |
| 4 | 1902865355 | $73K |
| 5 | 1841266194 | $66K |
| 6 | Southern California Permanente Medical Group Baldwin Park, CA · Health Maintenance Organization | $59K |
| 7 | The General Hospital Corporation Boston, MA · General Acute Care Hospital | $55K |
| 8 | 1700816048 | $48K |
| 9 | Pikeville Medical Center Inc Pikeville, KY · General Acute Care Hospital | $43K |
| 10 | 1043279565 | $31K |
| 11 | Uch-mhs Colorado Springs, CO · General Acute Care Hospital | $24K |
| 12 | Boston Medical Center Corporation Boston, MA · General Acute Care Hospital | $22K |
| 13 | 1962157404 | $20K |
| 14 | Cambridge Public Health Commission Cambridge, MA · General Acute Care Hospital | $20K |
| 15 | 1871246835 | $20K |
| 16 | Southcoast Hospitals Group, Inc New Bedford, MA · General Acute Care Hospital | $19K |
| 17 | 1275988321 | $17K |
| 18 | 1013998426 | $16K |
| 19 | 1174555692 | $12K |
| 20 | Brigham & Womens Hospital Inc. Boston, MA · General Acute Care Hospital | $12K |
Showing top 20 of 38 providers billing this code