J1953
HCPCS Procedure Code
HCPCS code J1953 is the #3,825 most-billed Medicaid procedure code, with $1.1M in payments across 146K claims from 2018–2024. The national median cost per claim is $4.59. Costs vary widely — the 90th percentile is $29.55 per claim, 6.4× the median.
Total Paid
$1.1M
0.00% of all spending
Total Claims
146K
Providers
458
Avg Cost/Claim
$8
National Cost Distribution
How much do providers bill per claim for J1953? Based on 313 providers billing this code nationally.
Median
$4.59
Average
$13.30
Std Dev
$27.23
Max
$227.81
Percentile Distribution (Cost per Claim)
50% of providers bill between $1.26 and $12.66 per claim for this code.
90% bill between $0.16 and $29.55.
Top 1% bill above $145.04.
About This Procedure
HCPCS code J1953 was billed by 458 providers across 146K claims, totaling $1.1M in Medicaid payments from 2018–2024. This code was used for 110K 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
$4.59
Providers Billing
313
National Spending
$1.1M
Avg/Median Ratio
2.90×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for J1953
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1336328244 | $112K |
| 2 | 1114547114 | $77K |
| 3 | University Hospital Newark, NJ · General Acute Care Hospital | $77K |
| 4 | 1295181477 | $49K |
| 5 | Pikeville Medical Center Inc Pikeville, KY · General Acute Care Hospital | $39K |
| 6 | Uofl Health-louisville Inc Louisville, KY · Psychiatric Hospital | $33K |
| 7 | 1336279959 | $27K |
| 8 | Antelope Valley Health Care District Lancaster, CA · General Acute Care Hospital | $27K |
| 9 | 1407813660 | $26K |
| 10 | University Medical Center, Inc Louisville, KY · Student in an Organized Health Care Education/Training Program | $26K |
| 11 | Regents Of The University Of California Sacramento, CA · General Acute Care Hospital | $21K |
| 12 | Unm Hospital Albuquerque, NM · General Acute Care Hospital | $21K |
| 13 | 1417947490 | $17K |
| 14 | Grossmont Hospital Corporation La Mesa, CA · General Acute Care Hospital | $17K |
| 15 | 1194840421 | $16K |
| 16 | 1114367497 | $16K |
| 17 | 1477549756 | $15K |
| 18 | 1508856535 | $14K |
| 19 | Alameda Health System Oakland, CA · General Acute Care Hospital | $14K |
| 20 | 1134274897 | $14K |
Showing top 20 of 458 providers billing this code