J0736
HCPCS Procedure Code
HCPCS code J0736 is the #6,641 most-billed Medicaid procedure code, with $50K in payments across 15K claims from 2018–2024. The national median cost per claim is $1.78. Costs vary widely — the 90th percentile is $9.23 per claim, 5.2× the median.
Total Paid
$50K
0.00% of all spending
Total Claims
15K
Providers
142
Avg Cost/Claim
$3
National Cost Distribution
How much do providers bill per claim for J0736? Based on 96 providers billing this code nationally.
Median
$1.78
Average
$4.28
Std Dev
$7.54
Max
$50.10
Percentile Distribution (Cost per Claim)
50% of providers bill between $0.64 and $4.81 per claim for this code.
90% bill between $0.15 and $9.23.
Top 1% bill above $40.78.
About This Procedure
HCPCS code J0736 was billed by 142 providers across 15K claims, totaling $50K in Medicaid payments from 2018–2024. This code was used for 11K 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
$1.78
Providers Billing
96
National Spending
$50K
Avg/Median Ratio
2.40×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for J0736
| # | Provider | Total Paid |
|---|---|---|
| 1 | Pikeville Medical Center Inc Pikeville, KY · General Acute Care Hospital | $13K |
| 2 | 1104856095 | $6K |
| 3 | Long Island Jewish Medical Center New Hyde Park, NY · General Acute Care Hospital | $2K |
| 4 | Seventh-day Adventists Loma Linda University Medical Center Loma Linda, CA · General Acute Care Hospital | $2K |
| 5 | 1609869916 | $2K |
| 6 | Ohiohealth Corporation Columbus, OH · General Acute Care Hospital | $2K |
| 7 | 1750353462 | $2K |
| 8 | Scottish Rite Children's Medical Center Atlanta, GA · Pediatrics Pediatric Hematology-Oncology | $2K |
| 9 | Ohiohealth Corporation Columbus, OH · General Acute Care Hospital | $1K |
| 10 | 1427055821 | $1K |
| 11 | Children's Hospital Medical Center Of Akron Akron, OH · General Acute Care Hospital Children | $1K |
| 12 | Arthur G James Cancer Hospital And Research Institute Columbus, OH · Special Hospital | $1K |
| 13 | 1598868655 | $1K |
| 14 | 1043293608 | $996 |
| 15 | 1356444814 | $934 |
| 16 | 1972535052 | $930 |
| 17 | Ohio State University Hospitals Columbus, OH · General Acute Care Hospital | $861 |
| 18 | 1730264128 | $779 |
| 19 | University Of Kentucky Lexington, KY · General Acute Care Hospital | $709 |
| 20 | 1205882503 | $680 |
Showing top 20 of 142 providers billing this code