J1250
HCPCS Procedure Code
HCPCS code J1250 is the #6,053 most-billed Medicaid procedure code, with $101K in payments across 15K claims from 2018–2024. The national median cost per claim is $2.87. Costs vary widely — the 90th percentile is $14.38 per claim, 5.0× the median.
Total Paid
$101K
0.00% of all spending
Total Claims
15K
Providers
64
Avg Cost/Claim
$7
National Cost Distribution
How much do providers bill per claim for J1250? Based on 47 providers billing this code nationally.
Median
$2.87
Average
$8.21
Std Dev
$20.03
Max
$131.16
Percentile Distribution (Cost per Claim)
50% of providers bill between $1.15 and $7.45 per claim for this code.
90% bill between $0.42 and $14.38.
Top 1% bill above $88.28.
About This Procedure
HCPCS code J1250 was billed by 64 providers across 15K claims, totaling $101K in Medicaid payments from 2018–2024. This code was used for 9,651 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
$2.87
Providers Billing
47
National Spending
$101K
Avg/Median Ratio
2.86×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for J1250
| # | Provider | Total Paid |
|---|---|---|
| 1 | University Of Utah Salt Lake City, UT · Clinic/Center, Dental | $47K |
| 2 | Arrowhead Regional Medical Center Colton, CA · General Acute Care Hospital | $13K |
| 3 | Seventh-day Adventists Loma Linda University Medical Center Loma Linda, CA · General Acute Care Hospital | $8K |
| 4 | 1912958174 | $7K |
| 5 | 1114099488 | $5K |
| 6 | 1518902147 | $4K |
| 7 | 1245351014 | $4K |
| 8 | Kern County Hospital Authority Bakersfield, CA · General Acute Care Hospital | $3K |
| 9 | Stanford Health Care Stanford, CA · General Acute Care Hospital | $2K |
| 10 | St Lukes Roosevelt Hospital Center New York, NY · Case Management | $1K |
| 11 | Ohio State University Hospitals Columbus, OH · General Acute Care Hospital | $1K |
| 12 | Regents Of The University Of California San Diego, CA · General Acute Care Hospital | $901 |
| 13 | 1578532123 | $693 |
| 14 | University Of California Irvine Orange, CA · General Acute Care Hospital | $690 |
| 15 | Summa Health System Akron, OH · General Acute Care Hospital | $346 |
| 16 | Virginia Commonwealth University Health System Authority Richmond, VA · General Acute Care Hospital | $333 |
| 17 | 1477549756 | $324 |
| 18 | 1346244126 | $262 |
| 19 | 1598868655 | $260 |
| 20 | Norton Hospitals Inc Louisville, KY · General Acute Care Hospital | $215 |
Showing top 20 of 64 providers billing this code