J0585
Injection, onabotulinumtoxinA, 1 unit
Injection, onabotulinumtoxinA, 1 unit is the #279 most-billed Medicaid procedure code, with $506.8M in payments across 949K claims from 2018–2024. The national median cost per claim is $470.36. Costs vary widely — the 90th percentile is $1,054.79 per claim, 2.2× the median.
Total Paid
$506.8M
0.05% of all spending
Total Claims
949K
Providers
973
Avg Cost/Claim
$534
National Cost Distribution
How much do providers bill per claim for J0585? Based on 931 providers billing this code nationally.
Median
$470.36
Average
$553.50
Std Dev
$424.23
Max
$4,325.09
Percentile Distribution (Cost per Claim)
50% of providers bill between $278.05 and $726.72 per claim for this code.
90% bill between $121.99 and $1,054.79.
Top 1% bill above $1,917.83.
About This Procedure
HCPCS code J0585 (Injection, onabotulinumtoxinA, 1 unit) was billed by 973 providers across 949K claims, totaling $506.8M in Medicaid payments from 2018–2024. This code was used for 653K 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
This procedure is featured in our investigation: Specialty Drug Costs
Read the full analysis for context on billing patterns associated with this code.
Billing Statistics
Median Cost/Claim
$470.36
Providers Billing
931
National Spending
$506.8M
Avg/Median Ratio
1.18×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for J0585
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1083045140 | $20.5M |
| 2 | Arkansas Childrens Hospital Little Rock, AR · Clinic/Center, Critical Access Hospital | $10.7M |
| 3 | The Cleveland Clinic Foundation Cleveland, OH · General Acute Care Hospital | $10.1M |
| 4 | Accredo Health Group Inc Memphis, TN · Pharmacy | $8.1M |
| 5 | Presbyterian Healthcare Services Albuquerque, NM · Surgery | $7.2M |
| 6 | 1295842615 | $7.2M |
| 7 | Yale New Haven Hospital New Haven, CT · General Acute Care Hospital | $7.1M |
| 8 | 1255354130 | $6.8M |
| 9 | 1639134414 | $6.6M |
| 10 | Nationwide Children's Hospital Columbus, OH · General Acute Care Hospital | $6.5M |
| 11 | 1013942788 | $6.4M |
| 12 | Spectrum Health Primary Care Partners Grand Rapids, MI · Psychologist, Clinical Child & Adolescent | $6.3M |
| 13 | State Of Mississippi - University Of Mississippi Medical Center Jackson, MS · General Acute Care Hospital | $5.9M |
| 14 | 1710065933 | $5.8M |
| 15 | 1164491072 | $5.4M |
| 16 | Phoenix Children's Hospital Phoenix, AZ · General Acute Care Hospital Children | $5.4M |
| 17 | 1811206071 | $5.0M |
| 18 | Procare Pharmacy Direct, Llc. Monroeville, PA · Pharmacy, Community/Retail Pharmacy | $4.5M |
| 19 | 1669588158 | $4.3M |
| 20 | 1003860537 | $4.3M |
Showing top 20 of 973 providers billing this code