J1000
HCPCS Procedure Code
HCPCS code J1000 is the #7,338 most-billed Medicaid procedure code, with $21K in payments across 2K claims from 2018–2024. The national median cost per claim is $16.03. Costs vary widely — the 90th percentile is $34.62 per claim, 2.2× the median.
Total Paid
$21K
0.00% of all spending
Total Claims
2K
Providers
11
Avg Cost/Claim
$12
National Cost Distribution
How much do providers bill per claim for J1000? Based on 8 providers billing this code nationally.
Median
$16.03
Average
$19.24
Std Dev
$12.33
Max
$41.37
Percentile Distribution (Cost per Claim)
50% of providers bill between $11.61 and $24.90 per claim for this code.
90% bill between $8.70 and $34.62.
Top 1% bill above $40.70.
About This Procedure
HCPCS code J1000 was billed by 11 providers across 2K claims, totaling $21K in Medicaid payments from 2018–2024. This code was used for 1K 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
$16.03
Providers Billing
8
National Spending
$21K
Avg/Median Ratio
1.20×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for J1000
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1184610248 | $8K |
| 2 | 1366618019 | $4K |
| 3 | 1255469110 | $3K |
| 4 | 1710945969 | $2K |
| 5 | 1437125572 | $1K |
| 6 | 1376646646 | $826 |
| 7 | 1457420390 | $762 |
| 8 | 1467667626 | $408 |
| 9 | 1437681178 | $0 |
| 10 | 1518955541 | $0 |
| 11 | 1861571622 | $0 |
Showing top 11 of 11 providers billing this code