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

#3950 of 11K

J0665

HCPCS Procedure Code

HCPCS code J0665 is the #3,950 most-billed Medicaid procedure code, with $985K in payments across 631K claims from 2018–2024. The national median cost per claim is $0.23. Costs vary widely — the 90th percentile is $6.36 per claim, 27.7× the median.

Total Paid

$985K

0.00% of all spending

Total Claims

631K

Providers

1,267

Avg Cost/Claim

$2

National Cost Distribution

How much do providers bill per claim for J0665? Based on 896 providers billing this code nationally.

Median

$0.23

Average

$3.34

Std Dev

$16.04

Max

$284.23

Percentile Distribution (Cost per Claim)

p10
$0.01
p25
$0.03
Median
$0.23
p75
$1.82
p90
$6.36
p95
$11.06
p99
$48.25

50% of providers bill between $0.03 and $1.82 per claim for this code.

90% bill between $0.01 and $6.36.

Top 1% bill above $48.25.

About This Procedure

HCPCS code J0665 was billed by 1,267 providers across 631K claims, totaling $985K in Medicaid payments from 2018–2024. This code was used for 518K 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

$0.23

Providers Billing

896

National Spending

$985K

Avg/Median Ratio

14.52×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for J0665

#ProviderTotal Paid
11689744450$120K
2Seventh-day Adventists Loma Linda University Medical Center

Loma Linda, CA · General Acute Care Hospital

$55K
3Women & Infants Hospital Of Rhode Island

Providence, RI · Clinic/Center, Ambulatory Family Planning Facility

$39K
4Southern Baptist Hospital Of Florida Inc

Jacksonville, FL · General Acute Care Hospital Children

$34K
5Carolinas Medical Center

Charlotte, NC · General Acute Care Hospital

$32K
61104856095$30K
71386643294$30K
81225450588$27K
9Unm Hospital

Albuquerque, NM · General Acute Care Hospital

$24K
10The Nemours Foundation

Orlando, FL · General Acute Care Hospital Children

$23K
11Egleston Children's Hospital At Emory University Inc.

Atlanta, GA · Pediatrics Pediatric Emergency Medicine

$22K
121821017880$21K
131568460772$19K
141881647204$18K
151346244126$15K
16Boston Medical Center Corporation

Boston, MA · General Acute Care Hospital

$13K
171184654923$12K
181447200233$11K
191306871223$10K
20Children's Hospital Of Wisconsin, Inc.

Milwaukee, WI · Dentist, Pediatric Dentistry

$10K

Showing top 20 of 1,267 providers billing this code

Related Procedures