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

#6580 of 11K

J2470

HCPCS Procedure Code

HCPCS code J2470 is the #6,580 most-billed Medicaid procedure code, with $54K in payments across 51K claims from 2018–2024. The national median cost per claim is $0.86. Costs vary widely — the 90th percentile is $5.64 per claim, 6.6× the median.

Total Paid

$54K

0.00% of all spending

Total Claims

51K

Providers

522

Avg Cost/Claim

$1

National Cost Distribution

How much do providers bill per claim for J2470? Based on 277 providers billing this code nationally.

Median

$0.86

Average

$2.50

Std Dev

$5.40

Max

$61.95

Percentile Distribution (Cost per Claim)

p10
$0.09
p25
$0.27
Median
$0.86
p75
$3.29
p90
$5.64
p95
$7.53
p99
$20.89

50% of providers bill between $0.27 and $3.29 per claim for this code.

90% bill between $0.09 and $5.64.

Top 1% bill above $20.89.

About This Procedure

HCPCS code J2470 was billed by 522 providers across 51K claims, totaling $54K in Medicaid payments from 2018–2024. This code was used for 36K 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

$0.86

Providers Billing

277

National Spending

$54K

Avg/Median Ratio

2.91×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for J2470

#ProviderTotal Paid
11669424354$5K
21891059127$3K
31104856095$2K
41043293608$2K
5Pikeville Medical Center Inc

Pikeville, KY · General Acute Care Hospital

$1K
6Uofl Health-louisville Inc

Louisville, KY · Psychiatric Hospital

$1K
7Norton Hospitals, Inc

Louisville, KY · General Acute Care Hospital

$1K
81295181477$1K
9Southern Ohio Medical Center

Portsmouth, OH · Clinical Medical Laboratory

$1K
10Mcallen Hospitals L P

Edinburg, TX · General Acute Care Hospital

$1K
11Owensboro Health Inc

Owensboro, KY · General Acute Care Hospital

$935
121871547703$904
131447221742$866
141689761942$820
151114367497$745
161356496772$715
171245221050$692
181326107319$662
191639523004$638
201417947490$620

Showing top 20 of 522 providers billing this code