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

#2913 of 11K

J0775

HCPCS Procedure Code

HCPCS code J0775 is the #2,913 most-billed Medicaid procedure code, with $3.1M in payments across 323 claims from 2018–2024. The national median cost per claim is $8,630.80.

Total Paid

$3.1M

0.00% of all spending

Total Claims

323

Providers

2

Avg Cost/Claim

$9K

National Cost Distribution

How much do providers bill per claim for J0775? Based on 2 providers billing this code nationally.

Median

$8,630.80

Average

$8,630.80

Std Dev

$1,735.96

Max

$9,858.31

Percentile Distribution (Cost per Claim)

p10
$7,648.80
p25
$8,017.05
Median
$8,630.80
p75
$9,244.56
p90
$9,612.81
p95
$9,735.56
p99
$9,833.76

50% of providers bill between $8,017.05 and $9,244.56 per claim for this code.

90% bill between $7,648.80 and $9,612.81.

Top 1% bill above $9,833.76.

About This Procedure

HCPCS code J0775 was billed by 2 providers across 323 claims, totaling $3.1M in Medicaid payments from 2018–2024. This code was used for 281 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

$8,630.80

Providers Billing

2

National Spending

$3.1M

Avg/Median Ratio

1.00×

Normal distribution

Provider Coverage

We have 2 providers billing this code in our dataset. Individual provider breakdowns are available for top-spending procedure codes.

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