J1930
HCPCS Procedure Code
HCPCS code J1930 is the #3,054 most-billed Medicaid procedure code, with $2.6M in payments across 897 claims from 2018–2024. The national median cost per claim is $1,808.53. Costs vary widely — the 90th percentile is $4,052.34 per claim, 2.2× the median.
Total Paid
$2.6M
0.00% of all spending
Total Claims
897
Providers
6
Avg Cost/Claim
$3K
National Cost Distribution
How much do providers bill per claim for J1930? Based on 6 providers billing this code nationally.
Median
$1,808.53
Average
$2,168.83
Std Dev
$1,604.16
Max
$4,620.88
Percentile Distribution (Cost per Claim)
50% of providers bill between $915.60 and $3,146.37 per claim for this code.
90% bill between $645.63 and $4,052.34.
Top 1% bill above $4,564.03.
About This Procedure
HCPCS code J1930 was billed by 6 providers across 897 claims, totaling $2.6M in Medicaid payments from 2018–2024. This code was used for 824 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
$1,808.53
Providers Billing
6
National Spending
$2.6M
Avg/Median Ratio
1.20×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for J1930
| # | Provider | Total Paid |
|---|---|---|
| 1 | Mount Sinai Hospital New York, NY · Ambulance | $1.5M |
| 2 | 1528018389 | $784K |
| 3 | Froedtert Memorial Lutheran Hospital, Inc. Milwaukee, WI · Clinic/Center, Radiology | $152K |
| 4 | 1780653618 | $110K |
| 5 | Yale New Haven Hospital New Haven, CT · General Acute Care Hospital | $38K |
| 6 | Upmc Magee-womens Hospital Pittsburgh, PA · General Acute Care Hospital | $23K |
Showing top 6 of 6 providers billing this code