Statistical flags indicate unusual patterns — not proof of fraud or wrongdoing. Read our methodology

#6960 of 11K

J0287

HCPCS Procedure Code

HCPCS code J0287 is the #6,960 most-billed Medicaid procedure code, with $35K in payments across 987 claims from 2018–2024. The national median cost per claim is $122.84.

Total Paid

$35K

0.00% of all spending

Total Claims

987

Providers

3

Avg Cost/Claim

$35

National Cost Distribution

How much do providers bill per claim for J0287? Based on 2 providers billing this code nationally.

Median

$122.84

Average

$122.84

Std Dev

$163.21

Max

$238.25

Percentile Distribution (Cost per Claim)

p10
$30.52
p25
$65.14
Median
$122.84
p75
$180.54
p90
$215.16
p95
$226.70
p99
$235.94

50% of providers bill between $65.14 and $180.54 per claim for this code.

90% bill between $30.52 and $215.16.

Top 1% bill above $235.94.

About This Procedure

HCPCS code J0287 was billed by 3 providers across 987 claims, totaling $35K in Medicaid payments from 2018–2024. This code was used for 685 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

$122.84

Providers Billing

2

National Spending

$35K

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.