J0290
HCPCS Procedure Code
HCPCS code J0290 is the #6,376 most-billed Medicaid procedure code, with $70K in payments across 19K claims from 2018–2024. The national median cost per claim is $2.32. Costs vary widely — the 90th percentile is $11.39 per claim, 4.9× the median.
Total Paid
$70K
0.00% of all spending
Total Claims
19K
Providers
57
Avg Cost/Claim
$4
National Cost Distribution
How much do providers bill per claim for J0290? Based on 44 providers billing this code nationally.
Median
$2.32
Average
$5.57
Std Dev
$12.00
Max
$77.83
Percentile Distribution (Cost per Claim)
50% of providers bill between $0.84 and $5.33 per claim for this code.
90% bill between $0.41 and $11.39.
Top 1% bill above $52.48.
About This Procedure
HCPCS code J0290 was billed by 57 providers across 19K claims, totaling $70K in Medicaid payments from 2018–2024. This code was used for 13K 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
$2.32
Providers Billing
44
National Spending
$70K
Avg/Median Ratio
2.40×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for J0290
| # | Provider | Total Paid |
|---|---|---|
| 1 | Dallas County Hospital District Dallas, TX · Clinic/Center, Ambulatory Surgical | $22K |
| 2 | Childrens Hospital Of The Kings Daughters Inc Norfolk, VA · Social Worker, Clinical | $8K |
| 3 | Egleston Children's Hospital At Emory University Inc. Atlanta, GA · Pediatrics Pediatric Emergency Medicine | $5K |
| 4 | Cook Children's Medical Center Fort Worth, TX · General Acute Care Hospital Children | $5K |
| 5 | Scottish Rite Children's Medical Center Atlanta, GA · Pediatrics Pediatric Hematology-Oncology | $4K |
| 6 | Boston Medical Center Corporation Boston, MA · General Acute Care Hospital | $4K |
| 7 | 1891792495 | $3K |
| 8 | 1689744450 | $2K |
| 9 | New York City Health And Hospitals Corporation Brooklyn, NY · Internal Medicine | $2K |
| 10 | 1104890276 | $2K |
| 11 | 1477584993 | $1K |
| 12 | Norton Hospitals Inc Louisville, KY · General Acute Care Hospital | $1K |
| 13 | University Hospital Newark, NJ · General Acute Care Hospital | $1K |
| 14 | Atlanticare Regional Medical Center Pomona, NJ · General Acute Care Hospital | $1K |
| 15 | Norton Hospitals, Inc Louisville, KY · General Acute Care Hospital | $908 |
| 16 | 1811080526 | $750 |
| 17 | Vhs Childrens Hospital Of Michigan Inc Detroit, MI · Clinic/Center, Ambulatory Surgical | $640 |
| 18 | 1083854434 | $611 |
| 19 | Variety Children's Hospital Miami, FL · General Acute Care Hospital Children | $495 |
| 20 | 1992176655 | $472 |
Showing top 20 of 57 providers billing this code