Statistical flags indicate unusual patterns — not proof of fraud or wrongdoing. Read our methodology

#7687 of 11K

J2305

HCPCS Procedure Code

HCPCS code J2305 is the #7,687 most-billed Medicaid procedure code, with $12K in payments across 9K claims from 2018–2024. The national median cost per claim is $0.52. Costs vary widely — the 90th percentile is $7.50 per claim, 14.4× the median.

Total Paid

$12K

0.00% of all spending

Total Claims

9K

Providers

96

Avg Cost/Claim

$1

National Cost Distribution

How much do providers bill per claim for J2305? Based on 52 providers billing this code nationally.

Median

$0.52

Average

$2.52

Std Dev

$3.71

Max

$16.16

Percentile Distribution (Cost per Claim)

p10
$0.02
p25
$0.14
Median
$0.52
p75
$3.58
p90
$7.50
p95
$9.78
p99
$15.17

50% of providers bill between $0.14 and $3.58 per claim for this code.

90% bill between $0.02 and $7.50.

Top 1% bill above $15.17.

About This Procedure

HCPCS code J2305 was billed by 96 providers across 9K claims, totaling $12K in Medicaid payments from 2018–2024. This code was used for 8K 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

$0.52

Providers Billing

52

National Spending

$12K

Avg/Median Ratio

4.85×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for J2305

#ProviderTotal Paid
11043293608$3K
2Nyu Langone Hospitals

New York, NY · Clinic/Center, Oncology

$2K
31770581894$1K
4Nyu Langone Hospitals

Brooklyn, NY · General Acute Care Hospital

$935
51396087672$792
6Regents Of The University Of California

San Diego, CA · General Acute Care Hospital

$585
7Hmh Hospitals Corporation

Edison, NJ · General Acute Care Hospital

$492
81821250762$414
91306914213$361
10Atlanticare Regional Medical Center

Pomona, NJ · General Acute Care Hospital

$303
111679816201$271
121306281126$212
13Uofl Health-louisville Inc

Louisville, KY · Psychiatric Hospital

$199
14Montefiore Medical Center

Bronx, NY · General Acute Care Hospital

$191
151831188275$141
16Children's Hospital Corporation

Boston, MA · Clinic/Center

$119
17Stanford Health Care

Stanford, CA · General Acute Care Hospital

$111
18The New York And Presbyterian Hospital

New York, NY · General Acute Care Hospital

$88
191639172372$85
20Henry Ford Health System

Detroit, MI · General Acute Care Hospital

$83

Showing top 20 of 96 providers billing this code