J1921
HCPCS Procedure Code
HCPCS code J1921 is the #8,954 most-billed Medicaid procedure code, with $685 in payments across 765 claims from 2018–2024. The national median cost per claim is $0.46. Costs vary widely — the 90th percentile is $8.50 per claim, 18.5× the median.
Total Paid
$685
0.00% of all spending
Total Claims
765
Providers
12
Avg Cost/Claim
$1
National Cost Distribution
How much do providers bill per claim for J1921? Based on 7 providers billing this code nationally.
Median
$0.46
Average
$3.10
Std Dev
$4.63
Max
$12.51
Percentile Distribution (Cost per Claim)
50% of providers bill between $0.28 and $4.06 per claim for this code.
90% bill between $0.12 and $8.50.
Top 1% bill above $12.11.
About This Procedure
HCPCS code J1921 was billed by 12 providers across 765 claims, totaling $685 in Medicaid payments from 2018–2024. This code was used for 677 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
$0.46
Providers Billing
7
National Spending
$685
Avg/Median Ratio
6.74×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for J1921
| # | Provider | Total Paid |
|---|---|---|
| 1 | Lexington Health Inc West Columbia, SC · General Acute Care Hospital | $390 |
| 2 | Nyu Langone Hospitals New York, NY · Clinic/Center, Oncology | $188 |
| 3 | 1710109186 | $46 |
| 4 | 1629009964 | $26 |
| 5 | 1548296106 | $18 |
| 6 | Hartford Hospital Hartford, CT · General Acute Care Hospital | $10 |
| 7 | 1912007931 | $8 |
| 8 | Boston Medical Center Corporation Boston, MA · General Acute Care Hospital | $0 |
| 9 | Rector & Visitors Of The University Of Virginia Charlottesville, VA · General Acute Care Hospital | $0 |
| 10 | 1093713091 | $0 |
| 11 | 1790868982 | $0 |
| 12 | 1811951429 | $0 |
Showing top 12 of 12 providers billing this code