J1572
HCPCS Procedure Code
HCPCS code J1572 is the #8,291 most-billed Medicaid procedure code, with $4K in payments across 16 claims from 2018–2024. The national median cost per claim is $261.04.
Total Paid
$4K
0.00% of all spending
Total Claims
16
Providers
1
Avg Cost/Claim
$261
National Cost Distribution
How much do providers bill per claim for J1572? Based on 1 providers billing this code nationally.
Median
$261.04
Average
$261.04
Std Dev
—
Max
$261.04
Percentile Distribution (Cost per Claim)
50% of providers bill between $261.04 and $261.04 per claim for this code.
90% bill between $261.04 and $261.04.
Top 1% bill above $261.04.
About This Procedure
HCPCS code J1572 was billed by 1 providers across 16 claims, totaling $4K in Medicaid payments from 2018–2024. This code was used for 16 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
$261.04
Providers Billing
1
National Spending
$4K
Avg/Median Ratio
1.00×
Normal distribution
Provider Coverage
We have 1 providers billing this code in our dataset. Individual provider breakdowns are available for top-spending procedure codes.