J1627
HCPCS Procedure Code
HCPCS code J1627 is the #6,546 most-billed Medicaid procedure code, with $57K in payments across 685 claims from 2018–2024. The national median cost per claim is $150.75. Costs vary widely — the 90th percentile is $370.74 per claim, 2.5× the median.
Total Paid
$57K
0.00% of all spending
Total Claims
685
Providers
5
Avg Cost/Claim
$83
National Cost Distribution
How much do providers bill per claim for J1627? Based on 5 providers billing this code nationally.
Median
$150.75
Average
$176.97
Std Dev
$196.28
Max
$509.31
Percentile Distribution (Cost per Claim)
50% of providers bill between $39.11 and $162.89 per claim for this code.
90% bill between $29.33 and $370.74.
Top 1% bill above $495.45.
About This Procedure
HCPCS code J1627 was billed by 5 providers across 685 claims, totaling $57K in Medicaid payments from 2018–2024. This code was used for 463 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
$150.75
Providers Billing
5
National Spending
$57K
Avg/Median Ratio
1.17×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for J1627
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1639109457 | $29K |
| 2 | 1083661607 | $19K |
| 3 | 1467406918 | $3K |
| 4 | 1619925369 | $3K |
| 5 | 1811955917 | $2K |
Showing top 5 of 5 providers billing this code