J0476
HCPCS Procedure Code
HCPCS code J0476 is the #8,403 most-billed Medicaid procedure code, with $3K in payments across 53 claims from 2018–2024. The national median cost per claim is $61.21.
Total Paid
$3K
0.00% of all spending
Total Claims
53
Providers
1
Avg Cost/Claim
$61
National Cost Distribution
How much do providers bill per claim for J0476? Based on 1 providers billing this code nationally.
Median
$61.21
Average
$61.21
Std Dev
—
Max
$61.21
Percentile Distribution (Cost per Claim)
50% of providers bill between $61.21 and $61.21 per claim for this code.
90% bill between $61.21 and $61.21.
Top 1% bill above $61.21.
About This Procedure
HCPCS code J0476 was billed by 1 providers across 53 claims, totaling $3K in Medicaid payments from 2018–2024. This code was used for 36 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
$61.21
Providers Billing
1
National Spending
$3K
Avg/Median Ratio
1.00×
Normal distribution
Provider Coverage
We have 1 providers billing this code in our dataset. Individual provider breakdowns are available for top-spending procedure codes.