J0690
HCPCS Procedure Code
HCPCS code J0690 is the #1,379 most-billed Medicaid procedure code, with $25.1M in payments across 5.0M claims from 2018–2024. The national median cost per claim is $0.94. Costs vary widely — the 90th percentile is $10.86 per claim, 11.6× the median.
Total Paid
$25.1M
0.00% of all spending
Total Claims
5.0M
Providers
2K
Avg Cost/Claim
$5
National Cost Distribution
How much do providers bill per claim for J0690? Based on 2K providers billing this code nationally.
Median
$0.94
Average
$7.20
Std Dev
$37.49
Max
$978.16
Percentile Distribution (Cost per Claim)
50% of providers bill between $0.13 and $4.25 per claim for this code.
90% bill between $0.02 and $10.86.
Top 1% bill above $103.09.
About This Procedure
HCPCS code J0690 was billed by 2K providers across 5.0M claims, totaling $25.1M in Medicaid payments from 2018–2024. This code was used for 3.8M 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
$0.94
Providers Billing
2K
National Spending
$25.1M
Avg/Median Ratio
7.66×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for J0690
| # | Provider | Total Paid |
|---|---|---|
| 1 | University Of Utah Salt Lake City, UT · Clinic/Center, Dental | $4.7M |
| 2 | Rhode Island Hospital Providence, RI · General Acute Care Hospital | $2.4M |
| 3 | Carolinas Medical Center Charlotte, NC · General Acute Care Hospital | $1.5M |
| 4 | 1104856095 | $1.2M |
| 5 | Charleston Area Medical Center Inc Charleston, WV · General Acute Care Hospital | $871K |
| 6 | The Miriam Hospital Providence, RI · General Acute Care Hospital | $719K |
| 7 | West Virginia University Hospitals, Inc Morgantown, WV · Clinical Medical Laboratory | $636K |
| 8 | 1073518007 | $588K |
| 9 | 1184606600 | $307K |
| 10 | 1477584993 | $299K |
| 11 | 1801861190 | $247K |
| 12 | 1386643294 | $246K |
| 13 | St. Mary's Medical Center Inc Huntington, WV · General Acute Care Hospital | $236K |
| 14 | Seventh-day Adventists Loma Linda University Medical Center Loma Linda, CA · General Acute Care Hospital | $231K |
| 15 | Adventist Health System-sunbelt, Inc Orlando, FL · Ambulance, Land Transport | $173K |
| 16 | 1750332565 | $166K |
| 17 | Uofl Health-louisville Inc Louisville, KY · Psychiatric Hospital | $156K |
| 18 | Boston Medical Center Corporation Boston, MA · General Acute Care Hospital | $147K |
| 19 | 1265423917 | $127K |
| 20 | Baystate Medical Center Inc Springfield, MA · General Acute Care Hospital | $125K |
Showing top 20 of 2K providers billing this code