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

#8949 of 11K

J2540

HCPCS Procedure Code

HCPCS code J2540 is the #8,949 most-billed Medicaid procedure code, with $696 in payments across 457 claims from 2018–2024. The national median cost per claim is $2.84.

Total Paid

$696

0.00% of all spending

Total Claims

457

Providers

4

Avg Cost/Claim

$2

National Cost Distribution

How much do providers bill per claim for J2540? Based on 4 providers billing this code nationally.

Median

$2.84

Average

$2.87

Std Dev

$2.51

Max

$5.20

Percentile Distribution (Cost per Claim)

p10
$0.65
p25
$0.76
Median
$2.84
p75
$4.95
p90
$5.10
p95
$5.15
p99
$5.19

50% of providers bill between $0.76 and $4.95 per claim for this code.

90% bill between $0.65 and $5.10.

Top 1% bill above $5.19.

About This Procedure

HCPCS code J2540 was billed by 4 providers across 457 claims, totaling $696 in Medicaid payments from 2018–2024. This code was used for 391 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

$2.84

Providers Billing

4

National Spending

$696

Avg/Median Ratio

1.01×

Normal distribution

Provider Coverage

We have 4 providers billing this code in our dataset. Individual provider breakdowns are available for top-spending procedure codes.