#2338 of 11K

J1335

HCPCS Procedure Code

HCPCS code J1335 is the #2,338 most-billed Medicaid procedure code, with $6.6M in payments across 41K claims from 2018–2024. The national median cost per claim is $100.54. Costs vary widely — the 90th percentile is $505.18 per claim, 5.0× the median.

Total Paid

$6.6M

0.00% of all spending

Total Claims

41K

Providers

Avg Cost/Claim

$160

National Cost Distribution

How much do providers bill per claim for J1335? Based on 46 providers billing this code nationally.

Median

$100.54

Average

$184.68

Std Dev

$194.17

Max

$629.73

Percentile Distribution (Cost per Claim)

p10

$3.70

p25

$29.12

Median

$100.54

p75

$337.09

p90

$505.18

p95

$544.94

p99

$625.18

50% of providers bill between $29.12 and $337.09 per claim for this code.

90% bill between $3.70 and $505.18.

Top 1% bill above $625.18.

About This Procedure

HCPCS code J1335 was billed by 50 providers across 41K claims, totaling $6.6M in Medicaid payments from 2018–2024. This code was used for 11K 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

$100.54

Providers Billing

National Spending

$6.6M

Avg/Median Ratio

1.84×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for J1335

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1518036458	$1.1M	$384.48	3.8× median	Above 75th
2	1881915031	$897K	$619.62	6.2× median	Top 10%
3	1568474716	$828K	$537.70	5.3× median	Top 10%
4	Best Option Healthcare Puerto Rico Llc San Juan, PR · Pharmacy Home Infusion Therapy Pharmacy	$820K	$497.35	4.9× median	Above 75th
5	1639403330	$663K	$51.58	0.5× median	Below Median
6	1679678049	$281K	$302.73	3.0× median	Above Median
7	1831241033	$272K	$400.75	4.0× median	Above 75th
8	1144560434	$270K	$268.52	2.7× median	Above Median
9	1114099488	$239K	$203.28	2.0× median	Above Median
10	1992777510	$219K	$513.02	5.1× median	Top 10%
11	1508850926	$192K	$406.42	4.0× median	Above 75th
12	1447268230	$178K	$547.36	5.4× median	Top 10%
13	1275812935	$178K	$89.17	0.9× median	Below Median
14	Optum Infusion Services 308 Llc Chandler, AZ · Pharmacy Home Infusion Therapy Pharmacy	$116K	$90.77	0.9× median	Below Median
15	1235125717	$41K	$29.75	0.3× median	Below Median
16	1942252499	$27K	$113.23	1.1× median	Above Median
17	1063284115	$25K	$77.89	0.8× median	Below Median
18	1356348866	$24K	$436.47	4.3× median	Above 75th
19	1619478047	$23K	$22.98	0.2× median	Below Median
20	1457872632	$20K	$184.37	1.8× median	Above Median

Showing top 20 of 50 providers billing this code

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J1325$6.2M J1330$6

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