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

#931 of 11K

J1885

Injection, ketorolac tromethamine, fifteen milligrams

Injection, ketorolac tromethamine, fifteen milligrams is the #931 most-billed Medicaid procedure code, with $57.1M in payments across 24.7M claims from 2018–2024. The national median cost per claim is $0.91. Costs vary widely — the 90th percentile is $5.75 per claim, 6.3× the median.

Total Paid

$57.1M

0.01% of all spending

Total Claims

24.7M

Providers

8K

Avg Cost/Claim

$2

National Cost Distribution

How much do providers bill per claim for J1885? Based on 7K providers billing this code nationally.

Median

$0.91

Average

$2.94

Std Dev

$11.55

Max

$466.11

Percentile Distribution (Cost per Claim)

p10
$0.03
p25
$0.22
Median
$0.91
p75
$2.08
p90
$5.75
p95
$10.43
p99
$31.35

50% of providers bill between $0.22 and $2.08 per claim for this code.

90% bill between $0.03 and $5.75.

Top 1% bill above $31.35.

About This Procedure

HCPCS code J1885 (Injection, ketorolac tromethamine, fifteen milligrams) was billed by 8K providers across 24.7M claims, totaling $57.1M in Medicaid payments from 2018–2024. This code was used for 20.7M 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

$0.91

Providers Billing

7K

National Spending

$57.1M

Avg/Median Ratio

3.23×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for J1885

#ProviderTotal Paid
1University Of Utah

Salt Lake City, UT · Clinic/Center, Dental

$3.2M
21376513754$1.9M
3Charleston Area Medical Center Inc

Charleston, WV · General Acute Care Hospital

$1.2M
4Yukon-kuskokwim Health Corporation

Bethel, AK · General Acute Care Hospital Rural

$847K
5Rhode Island Hospital

Providence, RI · General Acute Care Hospital

$798K
61831188275$730K
7The Miriam Hospital

Providence, RI · General Acute Care Hospital

$730K
81144228446$719K
9Childrens Hospital Of Philadelphia

Philadelphia, PA · General Acute Care Hospital Children

$688K
101013332014$462K
111073518007$438K
121386643294$436K
131114367497$379K
14West Virginia University Hospitals, Inc

Morgantown, WV · Clinical Medical Laboratory

$377K
151417952748$370K
16Mcallen Hospitals L P

Edinburg, TX · General Acute Care Hospital

$340K
171588959084$334K
18Trinitas Regional Medical Center

Elizabeth, NJ · General Acute Care Hospital

$319K
191871556217$314K
20Uofl Health-louisville Inc

Louisville, KY · Psychiatric Hospital

$299K

Showing top 20 of 8K providers billing this code

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