J0735
HCPCS Procedure Code
HCPCS code J0735 is the #5,359 most-billed Medicaid procedure code, with $220K in payments across 32K claims from 2018–2024. The national median cost per claim is $7.27. Costs vary widely — the 90th percentile is $21.83 per claim, 3.0× the median.
Total Paid
$220K
0.00% of all spending
Total Claims
32K
Providers
79
Avg Cost/Claim
$7
National Cost Distribution
How much do providers bill per claim for J0735? Based on 52 providers billing this code nationally.
Median
$7.27
Average
$11.79
Std Dev
$19.03
Max
$106.85
Percentile Distribution (Cost per Claim)
50% of providers bill between $1.25 and $13.04 per claim for this code.
90% bill between $0.09 and $21.83.
Top 1% bill above $87.80.
About This Procedure
HCPCS code J0735 was billed by 79 providers across 32K claims, totaling $220K in Medicaid payments from 2018–2024. This code was used for 26K 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
$7.27
Providers Billing
52
National Spending
$220K
Avg/Median Ratio
1.62×
Moderately skewed
Top Providers Billing This Code
Ranked by total Medicaid payments for J0735
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1336243393 | $79K |
| 2 | 1912403544 | $57K |
| 3 | 1720362866 | $17K |
| 4 | Dayton Children's Hospital Dayton, OH · General Acute Care Hospital, Children | $10K |
| 5 | St Elizabeth Medical Center, Inc Edgewood, KY · Portable X-Ray and/or Other Portable Diagnostic Imaging Supplier | $7K |
| 6 | 1487699047 | $7K |
| 7 | 1609153030 | $6K |
| 8 | 1295756641 | $5K |
| 9 | 1376630087 | $3K |
| 10 | 1497776397 | $3K |
| 11 | 1265539498 | $3K |
| 12 | 1972549855 | $3K |
| 13 | 1710920327 | $2K |
| 14 | 1164852190 | $2K |
| 15 | 1245234673 | $2K |
| 16 | Arrowhead Regional Medical Center Colton, CA · General Acute Care Hospital | $2K |
| 17 | 1881614071 | $1K |
| 18 | 1538119391 | $1K |
| 19 | 1447457775 | $953 |
| 20 | 1962722793 | $862 |
Showing top 20 of 79 providers billing this code