J2403
HCPCS Procedure Code
HCPCS code J2403 is the #5,907 most-billed Medicaid procedure code, with $121K in payments across 2K claims from 2018–2024. The national median cost per claim is $63.82. Costs vary widely — the 90th percentile is $142.39 per claim, 2.2× the median.
Total Paid
$121K
0.00% of all spending
Total Claims
2K
Providers
14
Avg Cost/Claim
$65
National Cost Distribution
How much do providers bill per claim for J2403? Based on 14 providers billing this code nationally.
Median
$63.82
Average
$86.44
Std Dev
$96.69
Max
$385.50
Percentile Distribution (Cost per Claim)
50% of providers bill between $29.13 and $110.57 per claim for this code.
90% bill between $15.89 and $142.39.
Top 1% bill above $354.47.
About This Procedure
HCPCS code J2403 was billed by 14 providers across 2K claims, totaling $121K in Medicaid payments from 2018–2024. This code was used for 1K 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
$63.82
Providers Billing
14
National Spending
$121K
Avg/Median Ratio
1.35×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for J2403
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1952381881 | $53K |
| 2 | 1639177751 | $16K |
| 3 | 1588763189 | $10K |
| 4 | 1710936190 | $8K |
| 5 | 1487657862 | $7K |
| 6 | 1083931182 | $6K |
| 7 | 1861539694 | $5K |
| 8 | 1225137847 | $4K |
| 9 | 1205454626 | $3K |
| 10 | 1164472031 | $3K |
| 11 | 1275629081 | $2K |
| 12 | 1467429647 | $2K |
| 13 | 1487221404 | $950 |
| 14 | 1033420260 | $687 |
Showing top 14 of 14 providers billing this code