#2194 of 11K

J1030

Injection, methylprednisolone acetate, forty milligrams

Injection, methylprednisolone acetate, forty milligrams is the #2,194 most-billed Medicaid procedure code, with $8.0M in payments across 1.6M claims from 2018–2024. The national median cost per claim is $4.38. Costs vary widely — the 90th percentile is $9.78 per claim, 2.2× the median.

Total Paid

$8.0M

0.00% of all spending

Total Claims

1.6M

Providers

Avg Cost/Claim

National Cost Distribution

How much do providers bill per claim for J1030? Based on 3K providers billing this code nationally.

Median

$4.38

Average

$5.43

Std Dev

$7.01

Max

$160.11

Percentile Distribution (Cost per Claim)

p10

$0.65

p25

$2.23

Median

$4.38

p75

$6.47

p90

$9.78

p95

$12.82

p99

$33.46

50% of providers bill between $2.23 and $6.47 per claim for this code.

90% bill between $0.65 and $9.78.

Top 1% bill above $33.46.

About This Procedure

HCPCS code J1030 (Injection, methylprednisolone acetate, forty milligrams) was billed by 3K providers across 1.6M claims, totaling $8.0M in Medicaid payments from 2018–2024. This code was used for 1.4M 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

$4.38

Providers Billing

National Spending

$8.0M

Avg/Median Ratio

1.24×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for J1030

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	University Of Utah Salt Lake City, UT · Clinic/Center, Dental	$377K	$160.11	36.6× median	Top 1%
2	Montefiore Medical Center Bronx, NY · Anesthesiology	$181K	$7.05	1.6× median	Above 75th
3	1467418574	$139K	$4.98	1.1× median	Above Median
4	Fast Pace Medical Clinic Pllc Spring Hill, TN · Family Medicine	$117K	$3.67	0.8× median	Below Median
5	1396124293	$106K	$49.43	11.3× median	Top 1%
6	1720017528	$99K	$13.67	3.1× median	Top 10%
7	Pikeville Medical Center Inc Pikeville, KY · General Acute Care Hospital	$98K	$20.40	4.7× median	Top 10%
8	1407106339	$95K	$16.64	3.8× median	Top 10%
9	1720083769	$93K	$8.94	2.0× median	Above 75th
10	1083908750	$85K	$44.63	10.2× median	Top 1%
11	1104856095	$77K	$90.57	20.7× median	Top 1%
12	1447372487	$73K	$9.02	2.1× median	Above 75th
13	1215116231	$70K	$21.61	4.9× median	Top 10%
14	1821286766	$64K	$64.10	14.6× median	Top 1%
15	1336187475	$63K	$10.81	2.5× median	Top 10%
16	1427165596	$60K	$28.01	6.4× median	Top 10%
17	1699703959	$59K	$8.86	2.0× median	Above 75th
18	1003835141	$56K	$6.46	1.5× median	Above Median
19	1003058637	$54K	$3.12	0.7× median	Below Median
20	1114948288	$53K	$9.14	2.1× median	Above 75th

Showing top 20 of 3K providers billing this code

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