J1920
HCPCS Procedure Code
HCPCS code J1920 is the #7,327 most-billed Medicaid procedure code, with $21K in payments across 36K claims from 2018–2024. The national median cost per claim is $0.20. Costs vary widely — the 90th percentile is $6.95 per claim, 34.8× the median.
Total Paid
$21K
0.00% of all spending
Total Claims
36K
Providers
215
Avg Cost/Claim
$1
National Cost Distribution
How much do providers bill per claim for J1920? Based on 141 providers billing this code nationally.
Median
$0.20
Average
$1.47
Std Dev
$3.44
Max
$23.17
Percentile Distribution (Cost per Claim)
50% of providers bill between $0.03 and $0.91 per claim for this code.
90% bill between $0.01 and $6.95.
Top 1% bill above $17.18.
About This Procedure
HCPCS code J1920 was billed by 215 providers across 36K claims, totaling $21K in Medicaid payments from 2018–2024. This code was used for 27K 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
$0.20
Providers Billing
141
National Spending
$21K
Avg/Median Ratio
7.35×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for J1920
| # | Provider | Total Paid |
|---|---|---|
| 1 | Uofl Health-louisville Inc Louisville, KY · Psychiatric Hospital | $4K |
| 2 | 1265539498 | $2K |
| 3 | 1518018191 | $2K |
| 4 | Seventh-day Adventists Loma Linda University Medical Center Loma Linda, CA · General Acute Care Hospital | $1K |
| 5 | Boston Medical Center Corporation Boston, MA · General Acute Care Hospital | $1K |
| 6 | University Of Kentucky Lexington, KY · General Acute Care Hospital | $794 |
| 7 | Ohiohealth Corporation Columbus, OH · General Acute Care Hospital | $715 |
| 8 | University Medical Center, Inc Louisville, KY · Student in an Organized Health Care Education/Training Program | $542 |
| 9 | 1417901091 | $506 |
| 10 | Ohiohealth Corporation Columbus, OH · General Acute Care Hospital | $448 |
| 11 | Inspira Medical Centers Inc. Vineland, NJ · General Acute Care Hospital | $437 |
| 12 | 1245221050 | $375 |
| 13 | Owensboro Health Inc Owensboro, KY · General Acute Care Hospital | $373 |
| 14 | 1417947490 | $328 |
| 15 | 1124098421 | $321 |
| 16 | 1356444814 | $313 |
| 17 | Providence Health & Services Washington Anchorage, AK · General Acute Care Hospital | $306 |
| 18 | Baystate Medical Center Inc Springfield, MA · General Acute Care Hospital | $297 |
| 19 | Hmh Hospitals Corporation Neptune, NJ · General Acute Care Hospital | $295 |
| 20 | 1811922347 | $278 |
Showing top 20 of 215 providers billing this code