J0475
Injection, baclofen, ten milligrams
Injection, baclofen, ten milligrams is the #1,128 most-billed Medicaid procedure code, with $39.1M in payments across 96K claims from 2018–2024. The national median cost per claim is $384.42. Costs vary widely — the 90th percentile is $972.72 per claim, 2.5× the median.
Total Paid
$39.1M
0.00% of all spending
Total Claims
96K
Providers
145
Avg Cost/Claim
$406
National Cost Distribution
How much do providers bill per claim for J0475? Based on 143 providers billing this code nationally.
Median
$384.42
Average
$481.47
Std Dev
$406.07
Max
$3,256.08
Percentile Distribution (Cost per Claim)
50% of providers bill between $232.74 and $580.19 per claim for this code.
90% bill between $112.85 and $972.72.
Top 1% bill above $1,735.72.
About This Procedure
HCPCS code J0475 (Injection, baclofen, ten milligrams) was billed by 145 providers across 96K claims, totaling $39.1M in Medicaid payments from 2018–2024. This code was used for 80K 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
$384.42
Providers Billing
143
National Spending
$39.1M
Avg/Median Ratio
1.25×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for J0475
| # | Provider | Total Paid |
|---|---|---|
| 1 | Vanderbilt University Medical Center Nashville, TN · Psychiatric Unit | $3.7M |
| 2 | 1770528994 | $2.5M |
| 3 | 1275580318 | $2.1M |
| 4 | North Carolina Baptist Hospital Winston Salem, NC · General Acute Care Hospital | $1.7M |
| 5 | Phoenix Children's Hospital Phoenix, AZ · General Acute Care Hospital Children | $1.4M |
| 6 | 1336243393 | $1.3M |
| 7 | 1548210040 | $1.1M |
| 8 | 1346246931 | $1.0M |
| 9 | State Of Mississippi - University Of Mississippi Medical Center Jackson, MS · General Acute Care Hospital | $1.0M |
| 10 | 1891805727 | $1.0M |
| 11 | 1336245828 | $971K |
| 12 | 1629356431 | $966K |
| 13 | 1679514509 | $891K |
| 14 | Scottish Rite Children's Medical Center Atlanta, GA · Pediatrics Pediatric Hematology-Oncology | $889K |
| 15 | 1346403854 | $838K |
| 16 | 1114958584 | $766K |
| 17 | 1508819228 | $682K |
| 18 | Medical University Hospital Authority Charleston, SC · General Acute Care Hospital | $663K |
| 19 | Arkansas Childrens Hospital Little Rock, AR · Clinic/Center, Critical Access Hospital | $622K |
| 20 | 1710065933 | $619K |
Showing top 20 of 145 providers billing this code