J1610
HCPCS Procedure Code
HCPCS code J1610 is the #3,772 most-billed Medicaid procedure code, with $1.2M in payments across 13K claims from 2018–2024. The national median cost per claim is $78.85. Costs vary widely — the 90th percentile is $165.56 per claim, 2.1× the median.
Total Paid
$1.2M
0.00% of all spending
Total Claims
13K
Providers
55
Avg Cost/Claim
$89
National Cost Distribution
How much do providers bill per claim for J1610? Based on 52 providers billing this code nationally.
Median
$78.85
Average
$103.86
Std Dev
$105.67
Max
$630.71
Percentile Distribution (Cost per Claim)
50% of providers bill between $42.18 and $128.16 per claim for this code.
90% bill between $27.27 and $165.56.
Top 1% bill above $547.21.
About This Procedure
HCPCS code J1610 was billed by 55 providers across 13K claims, totaling $1.2M in Medicaid payments from 2018–2024. This code was used for 12K 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
$78.85
Providers Billing
52
National Spending
$1.2M
Avg/Median Ratio
1.32×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for J1610
| # | Provider | Total Paid |
|---|---|---|
| 1 | Stanford Health Care Stanford, CA · General Acute Care Hospital | $240K |
| 2 | Beth Israel Deaconess Medical Center, Inc. Boston, MA · General Acute Care Hospital | $199K |
| 3 | Phoenix Children's Hospital Phoenix, AZ · General Acute Care Hospital Children | $103K |
| 4 | Regents Of The University Of Michigan Ann Arbor, MI · Clinic/Center, End-Stage Renal Disease (ESRD) Treatment | $101K |
| 5 | Yale New Haven Hospital New Haven, CT · General Acute Care Hospital | $94K |
| 6 | University Of Kentucky Lexington, KY · General Acute Care Hospital | $45K |
| 7 | Memorial Hospital For Cancer And Allied Diseases New York, NY · Pharmacy | $41K |
| 8 | Mainehealth Portland, ME · Emergency Medicine | $38K |
| 9 | Spectrum Health Hospitals Grand Rapids, MI · General Acute Care Hospital | $37K |
| 10 | Froedtert Memorial Lutheran Hospital, Inc. Milwaukee, WI · Clinic/Center, Radiology | $35K |
| 11 | Keck Medical Center Of Usc Los Angeles, CA · General Acute Care Hospital | $32K |
| 12 | 1073517058 | $29K |
| 13 | 1457321036 | $21K |
| 14 | The Cleveland Clinic Foundation Cleveland, OH · General Acute Care Hospital | $18K |
| 15 | 1376593442 | $18K |
| 16 | Variety Children's Hospital Miami, FL · General Acute Care Hospital Children | $16K |
| 17 | 1922074434 | $14K |
| 18 | 1629015698 | $11K |
| 19 | 1275578064 | $10K |
| 20 | Norton Hospitals Inc Louisville, KY · General Acute Care Hospital | $10K |
Showing top 20 of 55 providers billing this code