J2469
Injection, palonosetron HCl, twenty-five micrograms
Injection, palonosetron HCl, twenty-five micrograms is the #1,163 most-billed Medicaid procedure code, with $36.2M in payments across 748K claims from 2018–2024. The national median cost per claim is $25.23. Costs vary widely — the 90th percentile is $104.72 per claim, 4.2× the median.
Total Paid
$36.2M
0.00% of all spending
Total Claims
748K
Providers
581
Avg Cost/Claim
$48
National Cost Distribution
How much do providers bill per claim for J2469? Based on 535 providers billing this code nationally.
Median
$25.23
Average
$48.13
Std Dev
$78.53
Max
$1,229.41
Percentile Distribution (Cost per Claim)
50% of providers bill between $7.87 and $65.16 per claim for this code.
90% bill between $4.21 and $104.72.
Top 1% bill above $337.69.
About This Procedure
HCPCS code J2469 (Injection, palonosetron HCl, twenty-five micrograms) was billed by 581 providers across 748K claims, totaling $36.2M in Medicaid payments from 2018–2024. This code was used for 422K 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
$25.23
Providers Billing
535
National Spending
$36.2M
Avg/Median Ratio
1.91×
Moderately skewed
Top Providers Billing This Code
Ranked by total Medicaid payments for J2469
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1104856095 | $5.0M |
| 2 | Dana-farber Cancer Institute, Inc. Boston, MA · General Acute Care Hospital | $1.8M |
| 3 | Rhode Island Hospital Providence, RI · General Acute Care Hospital | $1.1M |
| 4 | Yale New Haven Hospital New Haven, CT · General Acute Care Hospital | $719K |
| 5 | University Hospital Newark, NJ · General Acute Care Hospital | $644K |
| 6 | University Of Utah Salt Lake City, UT · Clinic/Center, Dental | $578K |
| 7 | Swedish Health Services Seattle, WA · General Acute Care Hospital | $556K |
| 8 | Memorial Hospital For Cancer And Allied Diseases New York, NY · Pharmacy | $553K |
| 9 | The General Hospital Corporation Boston, MA · General Acute Care Hospital | $536K |
| 10 | Baystate Medical Center Inc Springfield, MA · General Acute Care Hospital | $531K |
| 11 | The Cooper Health System Camden, NJ · General Acute Care Hospital | $512K |
| 12 | Umass Memorial Medical Center, Inc. Worcester, MA · General Acute Care Hospital | $500K |
| 13 | 1164493847 | $487K |
| 14 | 1497737183 | $438K |
| 15 | Regents Of The University Of California San Diego, CA · General Acute Care Hospital | $433K |
| 16 | Women & Infants Hospital Of Rhode Island Providence, RI · Clinic/Center, Ambulatory Family Planning Facility | $430K |
| 17 | 1457409674 | $426K |
| 18 | 1528018389 | $424K |
| 19 | 1598770471 | $407K |
| 20 | Norton Hospitals Inc Louisville, KY · General Acute Care Hospital | $402K |
Showing top 20 of 581 providers billing this code