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

#6329 of 11K

J0577

HCPCS Procedure Code

HCPCS code J0577 is the #6,329 most-billed Medicaid procedure code, with $73K in payments across 164 claims from 2018–2024. The national median cost per claim is $525.66.

Total Paid

$73K

0.00% of all spending

Total Claims

164

Providers

3

Avg Cost/Claim

$448

National Cost Distribution

How much do providers bill per claim for J0577? Based on 2 providers billing this code nationally.

Median

$525.66

Average

$525.66

Std Dev

$96.47

Max

$593.88

Percentile Distribution (Cost per Claim)

p10
$471.09
p25
$491.56
Median
$525.66
p75
$559.77
p90
$580.23
p95
$587.06
p99
$592.51

50% of providers bill between $491.56 and $559.77 per claim for this code.

90% bill between $471.09 and $580.23.

Top 1% bill above $592.51.

About This Procedure

HCPCS code J0577 was billed by 3 providers across 164 claims, totaling $73K in Medicaid payments from 2018–2024. This code was used for 87 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

$525.66

Providers Billing

2

National Spending

$73K

Avg/Median Ratio

1.00×

Normal distribution

Provider Coverage

We have 2 providers billing this code in our dataset. Individual provider breakdowns are available for top-spending procedure codes.