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

#6435 of 11K

J1740

HCPCS Procedure Code

HCPCS code J1740 is the #6,435 most-billed Medicaid procedure code, with $65K in payments across 2K claims from 2018–2024. The national median cost per claim is $38.68. Costs vary widely — the 90th percentile is $82.91 per claim, 2.1× the median.

Total Paid

$65K

0.00% of all spending

Total Claims

2K

Providers

8

Avg Cost/Claim

$35

National Cost Distribution

How much do providers bill per claim for J1740? Based on 5 providers billing this code nationally.

Median

$38.68

Average

$48.03

Std Dev

$35.82

Max

$107.76

Percentile Distribution (Cost per Claim)

p10
$21.49
p25
$36.68
Median
$38.68
p75
$45.64
p90
$82.91
p95
$95.34
p99
$105.28

50% of providers bill between $36.68 and $45.64 per claim for this code.

90% bill between $21.49 and $82.91.

Top 1% bill above $105.28.

About This Procedure

HCPCS code J1740 was billed by 8 providers across 2K claims, totaling $65K in Medicaid payments from 2018–2024. This code was used for 2K 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

$38.68

Providers Billing

5

National Spending

$65K

Avg/Median Ratio

1.24×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for J1740

#ProviderTotal Paid
11407805500$30K
21528080637$26K
31902092281$6K
41013929918$2K
5San Juan Regional Medical Center, Inc.

Farmington, NM · Audiologist

$546
61710913330$0
71962857896$0
81942267992$0

Showing top 8 of 8 providers billing this code