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

#6415 of 11K

J0576

HCPCS Procedure Code

HCPCS code J0576 is the #6,415 most-billed Medicaid procedure code, with $67K in payments across 178 claims from 2018–2024. The national median cost per claim is $593.36.

Total Paid

$67K

0.00% of all spending

Total Claims

178

Providers

5

Avg Cost/Claim

$374

National Cost Distribution

How much do providers bill per claim for J0576? Based on 2 providers billing this code nationally.

Median

$593.36

Average

$593.36

Std Dev

$652.98

Max

$1,055.08

Percentile Distribution (Cost per Claim)

p10
$223.98
p25
$362.50
Median
$593.36
p75
$824.22
p90
$962.74
p95
$1,008.91
p99
$1,045.85

50% of providers bill between $362.50 and $824.22 per claim for this code.

90% bill between $223.98 and $962.74.

Top 1% bill above $1,045.85.

About This Procedure

HCPCS code J0576 was billed by 5 providers across 178 claims, totaling $67K in Medicaid payments from 2018–2024. This code was used for 155 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

$593.36

Providers Billing

2

National Spending

$67K

Avg/Median Ratio

1.00×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for J0576

#ProviderTotal Paid
11083659502$62K
21942453220$4K
31467490425$0
41588260889$0
51881680718$0

Showing top 5 of 5 providers billing this code