J1817
HCPCS Procedure Code
HCPCS code J1817 is the #6,523 most-billed Medicaid procedure code, with $58K in payments across 21K claims from 2018–2024. The national median cost per claim is $0.98. Costs vary widely — the 90th percentile is $14.69 per claim, 15.0× the median.
Total Paid
$58K
0.00% of all spending
Total Claims
21K
Providers
60
Avg Cost/Claim
$3
National Cost Distribution
How much do providers bill per claim for J1817? Based on 34 providers billing this code nationally.
Median
$0.98
Average
$4.69
Std Dev
$8.33
Max
$32.18
Percentile Distribution (Cost per Claim)
50% of providers bill between $0.17 and $5.12 per claim for this code.
90% bill between $0.06 and $14.69.
Top 1% bill above $31.83.
About This Procedure
HCPCS code J1817 was billed by 60 providers across 21K claims, totaling $58K in Medicaid payments from 2018–2024. This code was used for 9,987 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
$0.98
Providers Billing
34
National Spending
$58K
Avg/Median Ratio
4.79×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for J1817
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1366659849 | $40K |
| 2 | 1902191992 | $7K |
| 3 | 1245259282 | $2K |
| 4 | 1427055821 | $2K |
| 5 | Phoenix Children's Hospital Phoenix, AZ · General Acute Care Hospital Children | $2K |
| 6 | 1700886322 | $837 |
| 7 | 1356307581 | $785 |
| 8 | University Of Cincinnati Medical Center, Llc Cincinnati, OH · General Acute Care Hospital | $770 |
| 9 | St. Barnabas Hospital Bronx, NY · General Acute Care Hospital | $498 |
| 10 | 1548366404 | $425 |
| 11 | 1093263055 | $397 |
| 12 | Presbyterian Healthcare Services Albuquerque, NM · Emergency Medicine | $385 |
| 13 | 1982604419 | $257 |
| 14 | The Brookdale Hospital Medical Center Brooklyn, NY · General Acute Care Hospital | $203 |
| 15 | 1831656354 | $197 |
| 16 | 1700017118 | $151 |
| 17 | Boston Medical Center Corporation Boston, MA · General Acute Care Hospital | $137 |
| 18 | The Cooper Health System Camden, NJ · General Acute Care Hospital | $137 |
| 19 | Children's Hospital Of Wisconsin, Inc. Milwaukee, WI · Dentist, Pediatric Dentistry | $116 |
| 20 | Tucson Medical Center Tucson, AZ · Clinic/Center, Hearing and Speech | $108 |
Showing top 20 of 60 providers billing this code