#6966 of 11K

J0670

HCPCS Procedure Code

HCPCS code J0670 is the #6,966 most-billed Medicaid procedure code, with $34K in payments across 38K claims from 2018–2024. The national median cost per claim is $0.61. Costs vary widely — the 90th percentile is $3.19 per claim, 5.2× the median.

Total Paid

$34K

0.00% of all spending

Total Claims

38K

Providers

Avg Cost/Claim

National Cost Distribution

How much do providers bill per claim for J0670? Based on 54 providers billing this code nationally.

Median

$0.61

Average

$1.19

Std Dev

$1.47

Max

$6.18

Percentile Distribution (Cost per Claim)

p10

$0.05

p25

$0.20

Median

$0.61

p75

$1.51

p90

$3.19

p95

$4.02

p99

$6.17

50% of providers bill between $0.20 and $1.51 per claim for this code.

90% bill between $0.05 and $3.19.

Top 1% bill above $6.17.

About This Procedure

HCPCS code J0670 was billed by 95 providers across 38K claims, totaling $34K in Medicaid payments from 2018–2024. This code was used for 30K 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

$0.61

Providers Billing

National Spending

$34K

Avg/Median Ratio

1.95×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for J0670

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1265727762	$14K	$2.56	4.2× median	Above 75th
2	Unm Hospital Albuquerque, NM · General Acute Care Hospital	$5K	$4.71	7.7× median	Top 10%
3	1215116231	$3K	$3.02	4.9× median	Above 75th
4	1467423186	$3K	$1.49	2.4× median	Above Median
5	1740269174	$2K	$3.65	6.0× median	Top 10%
6	Upmc Magee-womens Hospital Pittsburgh, PA · General Acute Care Hospital	$1K	$1.87	3.1× median	Above 75th
7	1548443351	$1K	$1.55	2.5× median	Above 75th
8	1013981554	$546	$3.05	5.0× median	Above 75th
9	1750578761	$513	$1.25	2.0× median	Above Median
10	1780906396	$454	$1.45	2.4× median	Above Median
11	Carolinas Medical Center Charlotte, NC · General Acute Care Hospital	$374	$0.89	1.5× median	Above Median
12	1568433480	$350	$0.24	0.4× median	Below Median
13	1083105548	$348	$0.09	0.2× median	Below Median
14	1922579192	$331	$1.03	1.7× median	Above Median
15	Uofl Health-louisville Inc Louisville, KY · Psychiatric Hospital	$291	$6.18	10.1× median	Top 1%
16	1699115188	$261	$0.23	0.4× median	Below Median
17	The General Hospital Corporation Boston, MA · General Acute Care Hospital	$228	$0.38	0.6× median	Below Median
18	University Medical Center, Inc Louisville, KY · Student in an Organized Health Care Education/Training Program	$197	$6.15	10.1× median	Top 10%
19	1376669952	$157	$0.21	0.3× median	Below Median
20	1508201898	$154	$0.59	1.0× median	Below Median

Showing top 20 of 95 providers billing this code

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