J0612
HCPCS Procedure Code
HCPCS code J0612 is the #6,366 most-billed Medicaid procedure code, with $71K in payments across 9K claims from 2018–2024. The national median cost per claim is $1.22. Costs vary widely — the 90th percentile is $14.41 per claim, 11.8× the median.
Total Paid
$71K
0.00% of all spending
Total Claims
9K
Providers
39
Avg Cost/Claim
$8
National Cost Distribution
How much do providers bill per claim for J0612? Based on 29 providers billing this code nationally.
Median
$1.22
Average
$8.35
Std Dev
$20.24
Max
$102.03
Percentile Distribution (Cost per Claim)
50% of providers bill between $0.48 and $6.29 per claim for this code.
90% bill between $0.04 and $14.41.
Top 1% bill above $86.64.
About This Procedure
HCPCS code J0612 was billed by 39 providers across 9K claims, totaling $71K in Medicaid payments from 2018–2024. This code was used for 5K 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
$1.22
Providers Billing
29
National Spending
$71K
Avg/Median Ratio
6.84×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for J0612
| # | Provider | Total Paid |
|---|---|---|
| 1 | Arthur G James Cancer Hospital And Research Institute Columbus, OH · Special Hospital | $36K |
| 2 | University Of California Irvine Orange, CA · General Acute Care Hospital | $14K |
| 3 | Seventh-day Adventists Loma Linda University Medical Center Loma Linda, CA · General Acute Care Hospital | $6K |
| 4 | Yale New Haven Hospital New Haven, CT · General Acute Care Hospital | $3K |
| 5 | Medical University Hospital Authority Charleston, SC · General Acute Care Hospital | $2K |
| 6 | Montefiore Medical Center Bronx, NY · General Acute Care Hospital | $2K |
| 7 | Nationwide Children's Hospital Columbus, OH · General Acute Care Hospital | $2K |
| 8 | University Of Cincinnati Medical Center, Llc Cincinnati, OH · General Acute Care Hospital | $1K |
| 9 | Long Island Jewish Medical Center New Hyde Park, NY · General Acute Care Hospital | $436 |
| 10 | Carolinas Medical Center Charlotte, NC · General Acute Care Hospital | $431 |
| 11 | Norton Hospitals, Inc Louisville, KY · General Acute Care Hospital | $411 |
| 12 | Ohiohealth Corporation Columbus, OH · General Acute Care Hospital | $411 |
| 13 | 1720084999 | $317 |
| 14 | University Of Kentucky Lexington, KY · General Acute Care Hospital | $260 |
| 15 | Presbyterian Healthcare Services Albuquerque, NM · Emergency Medicine | $211 |
| 16 | Virginia Commonwealth University Health System Authority Richmond, VA · General Acute Care Hospital | $166 |
| 17 | 1356496772 | $74 |
| 18 | State Of Mississippi - University Of Mississippi Medical Center Jackson, MS · General Acute Care Hospital | $70 |
| 19 | The Metrohealth System Cleveland, OH · General Acute Care Hospital | $62 |
| 20 | 1154435824 | $29 |
Showing top 20 of 39 providers billing this code