J1611
HCPCS Procedure Code
HCPCS code J1611 is the #6,417 most-billed Medicaid procedure code, with $66K in payments across 1,358 claims from 2018–2024. The national median cost per claim is $45.71.
Total Paid
$66K
0.00% of all spending
Total Claims
1,358
Providers
7
Avg Cost/Claim
$49
National Cost Distribution
How much do providers bill per claim for J1611? Based on 7 providers billing this code nationally.
Median
$45.71
Average
$48.14
Std Dev
$17.97
Max
$76.85
Percentile Distribution (Cost per Claim)
50% of providers bill between $35.24 and $59.22 per claim for this code.
90% bill between $29.77 and $66.89.
Top 1% bill above $75.86.
About This Procedure
HCPCS code J1611 was billed by 7 providers across 1,358 claims, totaling $66K in Medicaid payments from 2018–2024. This code was used for 1,263 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
$45.71
Providers Billing
7
National Spending
$66K
Avg/Median Ratio
1.05×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for J1611
| # | Provider | Total Paid |
|---|---|---|
| 1 | Regents Of The University Of Michigan Ann Arbor, MI · Clinic/Center, End-Stage Renal Disease (ESRD) Treatment | $35K |
| 2 | Yale New Haven Hospital New Haven, CT · General Acute Care Hospital | $19K |
| 3 | University Of Wisconsin Hospitals And Clinics Authority Madison, WI · General Acute Care Hospital | $4K |
| 4 | Ohio State University Hospitals Columbus, OH · General Acute Care Hospital | $4K |
| 5 | The Cleveland Clinic Foundation Cleveland, OH · General Acute Care Hospital | $3K |
| 6 | Regents Of The University Of California Sacramento, CA · General Acute Care Hospital | $922 |
| 7 | Spectrum Health Hospitals Grand Rapids, MI · General Acute Care Hospital | $783 |
Showing top 7 of 7 providers billing this code