Statistical flags indicate unusual patterns — not proof of fraud or wrongdoing. Read our methodology

#1890 of 11K

J1599

HCPCS Procedure Code

HCPCS code J1599 is the #1,890 most-billed Medicaid procedure code, with $12.1M in payments across 4,839 claims from 2018–2024. The national median cost per claim is $5,475.32.

Total Paid

$12.1M

0.00% of all spending

Total Claims

4,839

Providers

2

Avg Cost/Claim

$3K

National Cost Distribution

How much do providers bill per claim for J1599? Based on 2 providers billing this code nationally.

Median

$5,475.32

Average

$5,475.32

Std Dev

$4,677.83

Max

$8,783.05

Percentile Distribution (Cost per Claim)

p10
$2,829.14
p25
$3,821.46
Median
$5,475.32
p75
$7,129.18
p90
$8,121.50
p95
$8,452.27
p99
$8,716.89

50% of providers bill between $3,821.46 and $7,129.18 per claim for this code.

90% bill between $2,829.14 and $8,121.50.

Top 1% bill above $8,716.89.

About This Procedure

HCPCS code J1599 was billed by 2 providers across 4,839 claims, totaling $12.1M in Medicaid payments from 2018–2024. This code was used for 891 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

$5,475.32

Providers Billing

2

National Spending

$12.1M

Avg/Median Ratio

1.00×

Normal distribution

Provider Coverage

We have 2 providers billing this code in our dataset. Individual provider breakdowns are available for top-spending procedure codes.