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

#8386 of 11K

J0720

HCPCS Procedure Code

HCPCS code J0720 is the #8,386 most-billed Medicaid procedure code, with $3K in payments across 332 claims from 2018–2024. The national median cost per claim is $9.55.

Total Paid

$3K

0.00% of all spending

Total Claims

332

Providers

3

Avg Cost/Claim

$10

National Cost Distribution

How much do providers bill per claim for J0720? Based on 3 providers billing this code nationally.

Median

$9.55

Average

$11.00

Std Dev

$6.41

Max

$18.01

Percentile Distribution (Cost per Claim)

p10
$6.27
p25
$7.50
Median
$9.55
p75
$13.78
p90
$16.32
p95
$17.17
p99
$17.84

50% of providers bill between $7.50 and $13.78 per claim for this code.

90% bill between $6.27 and $16.32.

Top 1% bill above $17.84.

About This Procedure

HCPCS code J0720 was billed by 3 providers across 332 claims, totaling $3K in Medicaid payments from 2018–2024. This code was used for 154 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

$9.55

Providers Billing

3

National Spending

$3K

Avg/Median Ratio

1.15×

Normal distribution

Provider Coverage

We have 3 providers billing this code in our dataset. Individual provider breakdowns are available for top-spending procedure codes.