J1940
HCPCS Procedure Code
HCPCS code J1940 is the #4,373 most-billed Medicaid procedure code, with $628K in payments across 496K claims from 2018–2024. The national median cost per claim is $0.60. Costs vary widely — the 90th percentile is $6.14 per claim, 10.2× the median.
Total Paid
$628K
0.00% of all spending
Total Claims
496K
Providers
811
Avg Cost/Claim
$1
National Cost Distribution
How much do providers bill per claim for J1940? Based on 593 providers billing this code nationally.
Median
$0.60
Average
$3.14
Std Dev
$13.02
Max
$241.08
Percentile Distribution (Cost per Claim)
50% of providers bill between $0.09 and $2.50 per claim for this code.
90% bill between $0.02 and $6.14.
Top 1% bill above $32.04.
About This Procedure
HCPCS code J1940 was billed by 811 providers across 496K claims, totaling $628K in Medicaid payments from 2018–2024. This code was used for 302K 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
$0.60
Providers Billing
593
National Spending
$628K
Avg/Median Ratio
5.23×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for J1940
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1639124142 | $26K |
| 2 | Dallas County Hospital District Dallas, TX · Clinic/Center, Ambulatory Surgical | $25K |
| 3 | Charleston Area Medical Center Inc Charleston, WV · General Acute Care Hospital | $17K |
| 4 | Uofl Health-louisville Inc Louisville, KY · Psychiatric Hospital | $17K |
| 5 | 1225033020 | $16K |
| 6 | 1114367497 | $15K |
| 7 | 1043220650 | $15K |
| 8 | 1538141627 | $13K |
| 9 | Antelope Valley Health Care District Lancaster, CA · General Acute Care Hospital | $11K |
| 10 | Seventh-day Adventists Loma Linda University Medical Center Loma Linda, CA · General Acute Care Hospital | $11K |
| 11 | University Of Utah Salt Lake City, UT · Clinic/Center, Dental | $11K |
| 12 | Providence Health & Services Washington Anchorage, AK · General Acute Care Hospital | $10K |
| 13 | West Virginia University Hospitals, Inc Morgantown, WV · Clinical Medical Laboratory | $10K |
| 14 | Tarrant County Hospital District Fort Worth, TX · Clinic/Center, Ambulatory Family Planning Facility | $10K |
| 15 | Stanford Health Care Stanford, CA · General Acute Care Hospital | $10K |
| 16 | Owensboro Health Inc Owensboro, KY · General Acute Care Hospital | $9K |
| 17 | 1699756221 | $9K |
| 18 | 1295181477 | $9K |
| 19 | 1720537178 | $9K |
| 20 | Regents Of The University Of California Sacramento, CA · General Acute Care Hospital | $9K |
Showing top 20 of 811 providers billing this code