J1165
HCPCS Procedure Code
HCPCS code J1165 is the #8,382 most-billed Medicaid procedure code, with $3K in payments across 235 claims from 2018–2024. The national median cost per claim is $32.07.
Total Paid
$3K
0.00% of all spending
Total Claims
235
Providers
3
Avg Cost/Claim
$14
National Cost Distribution
How much do providers bill per claim for J1165? Based on 2 providers billing this code nationally.
Median
$32.07
Average
$32.07
Std Dev
$30.70
Max
$53.77
Percentile Distribution (Cost per Claim)
50% of providers bill between $21.21 and $42.92 per claim for this code.
90% bill between $14.70 and $49.43.
Top 1% bill above $53.34.
About This Procedure
HCPCS code J1165 was billed by 3 providers across 235 claims, totaling $3K in Medicaid payments from 2018–2024. This code was used for 186 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
$32.07
Providers Billing
2
National Spending
$3K
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.