J1240
HCPCS Procedure Code
HCPCS code J1240 is the #9,214 most-billed Medicaid procedure code, with $211 in payments across 8,738 claims from 2018–2024. The national median cost per claim is $0.04. Costs vary widely — the 90th percentile is $0.71 per claim, 17.8× the median.
Total Paid
$211
0.00% of all spending
Total Claims
8,738
Providers
12
Avg Cost/Claim
$0
National Cost Distribution
How much do providers bill per claim for J1240? Based on 5 providers billing this code nationally.
Median
$0.04
Average
$0.26
Std Dev
$0.47
Max
$1.10
Percentile Distribution (Cost per Claim)
50% of providers bill between $0.02 and $0.14 per claim for this code.
90% bill between $0.01 and $0.71.
Top 1% bill above $1.06.
About This Procedure
HCPCS code J1240 was billed by 12 providers across 8,738 claims, totaling $211 in Medicaid payments from 2018–2024. This code was used for 7,744 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
$0.04
Providers Billing
5
National Spending
$211
Avg/Median Ratio
6.50×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for J1240
| # | Provider | Total Paid |
|---|---|---|
| 1 | St Elizabeth Medical Center, Inc Edgewood, KY · Portable X-Ray and/or Other Portable Diagnostic Imaging Supplier | $149 |
| 2 | 1962422733 | $26 |
| 3 | Regents Of The University Of Michigan Ann Arbor, MI · Clinic/Center, End-Stage Renal Disease (ESRD) Treatment | $25 |
| 4 | 1376593442 | $7 |
| 5 | 1225041809 | $4 |
| 6 | 1831116441 | $0 |
| 7 | 1083644579 | $0 |
| 8 | Saint Francis Hospital And Medical Center Hartford, CT · General Acute Care Hospital | $0 |
| 9 | Yale New Haven Hospital New Haven, CT · General Acute Care Hospital | $0 |
| 10 | 1003985755 | $0 |
| 11 | 1790131050 | $0 |
| 12 | Vhs Childrens Hospital Of Michigan Inc Detroit, MI · Clinic/Center, Ambulatory Surgical | $0 |
Showing top 12 of 12 providers billing this code