J2175
HCPCS Procedure Code
HCPCS code J2175 is the #4,218 most-billed Medicaid procedure code, with $746K in payments across 295K claims from 2018–2024. The national median cost per claim is $1.55. Costs vary widely — the 90th percentile is $11.57 per claim, 7.5× the median.
Total Paid
$746K
0.00% of all spending
Total Claims
295K
Providers
515
Avg Cost/Claim
$3
National Cost Distribution
How much do providers bill per claim for J2175? Based on 355 providers billing this code nationally.
Median
$1.55
Average
$7.89
Std Dev
$32.68
Max
$418.21
Percentile Distribution (Cost per Claim)
50% of providers bill between $0.13 and $5.40 per claim for this code.
90% bill between $0.02 and $11.57.
Top 1% bill above $83.88.
About This Procedure
HCPCS code J2175 was billed by 515 providers across 295K claims, totaling $746K in Medicaid payments from 2018–2024. This code was used for 252K 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
$1.55
Providers Billing
355
National Spending
$746K
Avg/Median Ratio
5.09×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for J2175
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1811080526 | $96K |
| 2 | 1699704254 | $84K |
| 3 | 1235196510 | $33K |
| 4 | 1821002007 | $32K |
| 5 | 1750332565 | $29K |
| 6 | 1417064205 | $22K |
| 7 | Charleston Area Medical Center Inc Charleston, WV · General Acute Care Hospital | $21K |
| 8 | 1063441293 | $20K |
| 9 | 1679879589 | $19K |
| 10 | 1639124142 | $17K |
| 11 | 1992789721 | $16K |
| 12 | 1306909734 | $15K |
| 13 | 1992733513 | $15K |
| 14 | 1710065933 | $15K |
| 15 | 1053643783 | $12K |
| 16 | 1922033547 | $11K |
| 17 | 1184606600 | $10K |
| 18 | 1073504981 | $10K |
| 19 | 1043293608 | $10K |
| 20 | 1629007430 | $8K |
Showing top 20 of 515 providers billing this code