J1453
HCPCS Procedure Code
HCPCS code J1453 is the #1,346 most-billed Medicaid procedure code, with $26.3M in payments across 277K claims from 2018–2024. The national median cost per claim is $65.90. Costs vary widely — the 90th percentile is $221.73 per claim, 3.4× the median.
Total Paid
$26.3M
0.00% of all spending
Total Claims
277K
Providers
389
Avg Cost/Claim
$95
National Cost Distribution
How much do providers bill per claim for J1453? Based on 350 providers billing this code nationally.
Median
$65.90
Average
$100.86
Std Dev
$117.06
Max
$954.82
Percentile Distribution (Cost per Claim)
50% of providers bill between $26.89 and $130.97 per claim for this code.
90% bill between $12.13 and $221.73.
Top 1% bill above $652.91.
About This Procedure
HCPCS code J1453 was billed by 389 providers across 277K claims, totaling $26.3M in Medicaid payments from 2018–2024. This code was used for 165K 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
$65.90
Providers Billing
350
National Spending
$26.3M
Avg/Median Ratio
1.53×
Moderately skewed
Top Providers Billing This Code
Ranked by total Medicaid payments for J1453
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1396087672 | $1.5M |
| 2 | 1447539374 | $824K |
| 3 | Bakersfield Memorial Hospital Bakersfield, CA · General Acute Care Hospital | $794K |
| 4 | 1780107797 | $776K |
| 5 | Regents Of The University Of California San Diego, CA · General Acute Care Hospital | $671K |
| 6 | Beth Israel Deaconess Medical Center, Inc. Boston, MA · General Acute Care Hospital | $648K |
| 7 | University Of Utah Salt Lake City, UT · Clinic/Center, Dental | $599K |
| 8 | Stanford Health Care Stanford, CA · General Acute Care Hospital | $577K |
| 9 | Banner - University Medical Center Tucson Campus Llc Tucson, AZ · Clinic/Center, Multi-Specialty | $569K |
| 10 | Rector & Visitors Of The University Of Virginia Charlottesville, VA · General Acute Care Hospital | $544K |
| 11 | 1679660617 | $488K |
| 12 | Dana-farber Cancer Institute, Inc. Boston, MA · General Acute Care Hospital | $485K |
| 13 | Englewood Hospital And Medical Center Englewood, NJ · General Acute Care Hospital | $439K |
| 14 | 1457361271 | $398K |
| 15 | Rhode Island Hospital Providence, RI · General Acute Care Hospital | $385K |
| 16 | The General Hospital Corporation Boston, MA · General Acute Care Hospital | $360K |
| 17 | Montefiore Medical Center Bronx, NY · General Acute Care Hospital | $337K |
| 18 | 1770690695 | $311K |
| 19 | State Of Mississippi - University Of Mississippi Medical Center Jackson, MS · General Acute Care Hospital | $302K |
| 20 | Swedish Health Services Seattle, WA · General Acute Care Hospital | $301K |
Showing top 20 of 389 providers billing this code