J1170
Injection, hydromorphone, up to four milligrams
Injection, hydromorphone, up to four milligrams is the #1,552 most-billed Medicaid procedure code, with $19.5M in payments across 6.1M claims from 2018–2024. The national median cost per claim is $1.03. Costs vary widely — the 90th percentile is $9.50 per claim, 9.2× the median.
Total Paid
$19.5M
0.00% of all spending
Total Claims
6.1M
Providers
3K
Avg Cost/Claim
$3
National Cost Distribution
How much do providers bill per claim for J1170? Based on 2K providers billing this code nationally.
Median
$1.03
Average
$4.89
Std Dev
$18.53
Max
$278.64
Percentile Distribution (Cost per Claim)
50% of providers bill between $0.18 and $3.73 per claim for this code.
90% bill between $0.02 and $9.50.
Top 1% bill above $70.02.
About This Procedure
HCPCS code J1170 (Injection, hydromorphone, up to four milligrams) was billed by 3K providers across 6.1M claims, totaling $19.5M in Medicaid payments from 2018–2024. This code was used for 4.1M 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
$1.03
Providers Billing
2K
National Spending
$19.5M
Avg/Median Ratio
4.75×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for J1170
| # | Provider | Total Paid |
|---|---|---|
| 1 | Rhode Island Hospital Providence, RI · General Acute Care Hospital | $1.6M |
| 2 | University Of Utah Salt Lake City, UT · Clinic/Center, Dental | $1.3M |
| 3 | The Miriam Hospital Providence, RI · General Acute Care Hospital | $742K |
| 4 | 1376513754 | $570K |
| 5 | Charleston Area Medical Center Inc Charleston, WV · General Acute Care Hospital | $544K |
| 6 | 1336243393 | $422K |
| 7 | 1306871223 | $392K |
| 8 | 1104856095 | $256K |
| 9 | Seventh-day Adventists Loma Linda University Medical Center Loma Linda, CA · General Acute Care Hospital | $191K |
| 10 | Pikeville Medical Center Inc Pikeville, KY · General Acute Care Hospital | $167K |
| 11 | 1750332565 | $166K |
| 12 | Arthur G James Cancer Hospital And Research Institute Columbus, OH · Special Hospital | $150K |
| 13 | 1386643294 | $149K |
| 14 | 1073518007 | $148K |
| 15 | Uofl Health-louisville Inc Louisville, KY · Psychiatric Hospital | $138K |
| 16 | Vanderbilt University Medical Center Nashville, TN · Psychiatric Unit | $129K |
| 17 | 1134194038 | $128K |
| 18 | University Medical Center, Inc Louisville, KY · Student in an Organized Health Care Education/Training Program | $126K |
| 19 | Regents Of The University Of California Sacramento, CA · General Acute Care Hospital | $124K |
| 20 | Carolinas Medical Center Charlotte, NC · General Acute Care Hospital | $122K |
Showing top 20 of 3K providers billing this code