J2404
HCPCS Procedure Code
HCPCS code J2404 is the #8,662 most-billed Medicaid procedure code, with $2K in payments across 370 claims from 2018–2024. The national median cost per claim is $2.91. Costs vary widely — the 90th percentile is $33.58 per claim, 11.5× the median.
Total Paid
$2K
0.00% of all spending
Total Claims
370
Providers
8
Avg Cost/Claim
$4
National Cost Distribution
How much do providers bill per claim for J2404? Based on 5 providers billing this code nationally.
Median
$2.91
Average
$13.42
Std Dev
$18.25
Max
$42.79
Percentile Distribution (Cost per Claim)
50% of providers bill between $1.01 and $19.76 per claim for this code.
90% bill between $0.77 and $33.58.
Top 1% bill above $41.87.
About This Procedure
HCPCS code J2404 was billed by 8 providers across 370 claims, totaling $2K in Medicaid payments from 2018–2024. This code was used for 309 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
$2.91
Providers Billing
5
National Spending
$2K
Avg/Median Ratio
4.61×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for J2404
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1538244918 | $696 |
| 2 | 1720623853 | $556 |
| 3 | 1154419737 | $356 |
| 4 | 1245274950 | $30 |
| 5 | 1013994359 | $11 |
| 6 | Yale New Haven Hospital New Haven, CT · General Acute Care Hospital | $0 |
| 7 | 1699756221 | $0 |
| 8 | Temple University Hospital Inc Philadelphia, PA · General Acute Care Hospital | $0 |
Showing top 8 of 8 providers billing this code