J0780
HCPCS Procedure Code
HCPCS code J0780 is the #2,799 most-billed Medicaid procedure code, with $3.6M in payments across 869K claims from 2018–2024. The national median cost per claim is $1.24. Costs vary widely — the 90th percentile is $12.81 per claim, 10.3× the median.
Total Paid
$3.6M
0.00% of all spending
Total Claims
869K
Providers
1K
Avg Cost/Claim
$4
National Cost Distribution
How much do providers bill per claim for J0780? Based on 940 providers billing this code nationally.
Median
$1.24
Average
$6.50
Std Dev
$26.29
Max
$543.00
Percentile Distribution (Cost per Claim)
50% of providers bill between $0.17 and $6.05 per claim for this code.
90% bill between $0.04 and $12.81.
Top 1% bill above $85.05.
About This Procedure
HCPCS code J0780 was billed by 1K providers across 869K claims, totaling $3.6M in Medicaid payments from 2018–2024. This code was used for 741K 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
$1.24
Providers Billing
940
National Spending
$3.6M
Avg/Median Ratio
5.24×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for J0780
| # | Provider | Total Paid |
|---|---|---|
| 1 | University Of Utah Salt Lake City, UT · Clinic/Center, Dental | $764K |
| 2 | Antelope Valley Health Care District Lancaster, CA · General Acute Care Hospital | $400K |
| 3 | Rhode Island Hospital Providence, RI · General Acute Care Hospital | $119K |
| 4 | Regents Of The University Of California Sacramento, CA · General Acute Care Hospital | $70K |
| 5 | 1134194038 | $58K |
| 6 | Uofl Health-louisville Inc Louisville, KY · Psychiatric Hospital | $55K |
| 7 | 1073518007 | $52K |
| 8 | 1477671535 | $46K |
| 9 | University Medical Center, Inc Louisville, KY · Student in an Organized Health Care Education/Training Program | $42K |
| 10 | 1750384079 | $42K |
| 11 | West Virginia University Hospitals, Inc Morgantown, WV · Clinical Medical Laboratory | $38K |
| 12 | Norton Hospitals Inc Louisville, KY · General Acute Care Hospital | $34K |
| 13 | 1699129601 | $34K |
| 14 | 1073665360 | $33K |
| 15 | Stanford Health Care Stanford, CA · General Acute Care Hospital | $32K |
| 16 | 1457389249 | $29K |
| 17 | Seventh-day Adventists Loma Linda University Medical Center Loma Linda, CA · General Acute Care Hospital | $27K |
| 18 | Riverside University Health Systems - Medical Center Moreno Valley, CA · General Acute Care Hospital | $26K |
| 19 | 1194790055 | $26K |
| 20 | St Elizabeth Medical Center, Inc Edgewood, KY · Portable X-Ray and/or Other Portable Diagnostic Imaging Supplier | $26K |
Showing top 20 of 1K providers billing this code