J1230
HCPCS Procedure Code
HCPCS code J1230 is the #8,116 most-billed Medicaid procedure code, with $6K in payments across 1,439 claims from 2018–2024. The national median cost per claim is $8.26.
Total Paid
$6K
0.00% of all spending
Total Claims
1,439
Providers
3
Avg Cost/Claim
$4
National Cost Distribution
How much do providers bill per claim for J1230? Based on 2 providers billing this code nationally.
Median
$8.26
Average
$8.26
Std Dev
$7.10
Max
$13.28
Percentile Distribution (Cost per Claim)
50% of providers bill between $5.74 and $10.77 per claim for this code.
90% bill between $4.24 and $12.27.
Top 1% bill above $13.18.
About This Procedure
HCPCS code J1230 was billed by 3 providers across 1,439 claims, totaling $6K in Medicaid payments from 2018–2024. This code was used for 1,296 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
$8.26
Providers Billing
2
National Spending
$6K
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.