J0725
HCPCS Procedure Code
HCPCS code J0725 is the #7,307 most-billed Medicaid procedure code, with $22K in payments across 5K claims from 2018–2024. The national median cost per claim is $2.20. Costs vary widely — the 90th percentile is $8.61 per claim, 3.9× the median.
Total Paid
$22K
0.00% of all spending
Total Claims
5K
Providers
4
Avg Cost/Claim
$4
National Cost Distribution
How much do providers bill per claim for J0725? Based on 4 providers billing this code nationally.
Median
$2.20
Average
$4.19
Std Dev
$4.67
Max
$11.13
Percentile Distribution (Cost per Claim)
50% of providers bill between $1.56 and $4.83 per claim for this code.
90% bill between $1.35 and $8.61.
Top 1% bill above $10.88.
About This Procedure
HCPCS code J0725 was billed by 4 providers across 5K claims, totaling $22K in Medicaid payments from 2018–2024. This code was used for 2K 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
$2.20
Providers Billing
4
National Spending
$22K
Avg/Median Ratio
1.90×
Moderately skewed
Provider Coverage
We have 4 providers billing this code in our dataset. Individual provider breakdowns are available for top-spending procedure codes.