J0500
HCPCS Procedure Code
HCPCS code J0500 is the #4,126 most-billed Medicaid procedure code, with $828K in payments across 75K claims from 2018–2024. The national median cost per claim is $14.00. Costs vary widely — the 90th percentile is $53.20 per claim, 3.8× the median.
Total Paid
$828K
0.00% of all spending
Total Claims
75K
Providers
283
Avg Cost/Claim
$11
National Cost Distribution
How much do providers bill per claim for J0500? Based on 188 providers billing this code nationally.
Median
$14.00
Average
$21.76
Std Dev
$23.45
Max
$119.41
Percentile Distribution (Cost per Claim)
50% of providers bill between $2.96 and $32.00 per claim for this code.
90% bill between $0.28 and $53.20.
Top 1% bill above $92.74.
About This Procedure
HCPCS code J0500 was billed by 283 providers across 75K claims, totaling $828K in Medicaid payments from 2018–2024. This code was used for 66K 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
$14.00
Providers Billing
188
National Spending
$828K
Avg/Median Ratio
1.55×
Moderately skewed
Top Providers Billing This Code
Ranked by total Medicaid payments for J0500
| # | Provider | Total Paid |
|---|---|---|
| 1 | Uofl Health-louisville Inc Louisville, KY · Psychiatric Hospital | $67K |
| 2 | 1073519443 | $60K |
| 3 | 1821147786 | $50K |
| 4 | 1689282147 | $47K |
| 5 | 1740208081 | $42K |
| 6 | 1467808659 | $28K |
| 7 | Clara Maass Medical Center Belleville, NJ · General Acute Care Hospital | $23K |
| 8 | Mercy Health - St Vincent Medical Center Llc Toledo, OH · Ambulance, Land Transport | $20K |
| 9 | Miami Valley Hospital Dayton, OH · General Acute Care Hospital | $20K |
| 10 | 1861439952 | $20K |
| 11 | 1972549855 | $19K |
| 12 | 1134194038 | $18K |
| 13 | Grossmont Hospital Corporation La Mesa, CA · General Acute Care Hospital | $18K |
| 14 | Dayton Osteopathic Hospital Dayton, OH · General Acute Care Hospital | $17K |
| 15 | 1144286402 | $17K |
| 16 | 1720037799 | $16K |
| 17 | Norton Hospitals, Inc Louisville, KY · General Acute Care Hospital | $15K |
| 18 | Norton Hospitals Inc Louisville, KY · General Acute Care Hospital | $13K |
| 19 | 1619931466 | $13K |
| 20 | 1245221050 | $12K |
Showing top 20 of 283 providers billing this code