J0881
Injection, darbepoetin alfa, one microgram, non-ESRD
Injection, darbepoetin alfa, one microgram, non-ESRD is the #2,071 most-billed Medicaid procedure code, with $9.4M in payments across 63K claims from 2018–2024. The national median cost per claim is $109.46. Costs vary widely — the 90th percentile is $448.86 per claim, 4.1× the median.
Total Paid
$9.4M
0.00% of all spending
Total Claims
63K
Providers
102
Avg Cost/Claim
$150
National Cost Distribution
How much do providers bill per claim for J0881? Based on 96 providers billing this code nationally.
Median
$109.46
Average
$168.20
Std Dev
$192.81
Max
$1,016.05
Percentile Distribution (Cost per Claim)
50% of providers bill between $58.33 and $173.69 per claim for this code.
90% bill between $24.92 and $448.86.
Top 1% bill above $903.62.
About This Procedure
HCPCS code J0881 (Injection, darbepoetin alfa, one microgram, non-ESRD) was billed by 102 providers across 63K claims, totaling $9.4M in Medicaid payments from 2018–2024. This code was used for 41K 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
$109.46
Providers Billing
96
National Spending
$9.4M
Avg/Median Ratio
1.54×
Moderately skewed
Top Providers Billing This Code
Ranked by total Medicaid payments for J0881
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1326124819 | $1.4M |
| 2 | 1073665360 | $1.1M |
| 3 | Yale New Haven Hospital New Haven, CT · General Acute Care Hospital | $937K |
| 4 | Boston Medical Center Corporation Boston, MA · General Acute Care Hospital | $784K |
| 5 | 1497737183 | $530K |
| 6 | Dana-farber Cancer Institute, Inc. Boston, MA · General Acute Care Hospital | $464K |
| 7 | 1821271032 | $358K |
| 8 | 1083661607 | $352K |
| 9 | 1770728438 | $314K |
| 10 | Yuma Regional Medical Center Yuma, AZ · General Acute Care Hospital | $272K |
| 11 | Medstar Washington Hospital Center Washington, DC · General Acute Care Hospital | $246K |
| 12 | City Of Hope National Medical Center Duarte, CA · General Acute Care Hospital | $220K |
| 13 | 1992968150 | $198K |
| 14 | Public Hospital District 1 Of King County Renton, WA · General Acute Care Hospital | $158K |
| 15 | Svmc Holdings, Inc Bridgeport, CT · General Acute Care Hospital | $129K |
| 16 | The Hospital Of Central Connecticut At New Britain General And Bradley New Britain, CT · General Acute Care Hospital | $102K |
| 17 | 1912017575 | $99K |
| 18 | 1528035995 | $88K |
| 19 | Sage River Counseling Seattle, WA · Counselor Mental Health | $87K |
| 20 | 1598770471 | $85K |
Showing top 20 of 102 providers billing this code