J2545
HCPCS Procedure Code
HCPCS code J2545 is the #5,767 most-billed Medicaid procedure code, with $143K in payments across 1,211 claims from 2018–2024. The national median cost per claim is $140.38.
Total Paid
$143K
0.00% of all spending
Total Claims
1,211
Providers
6
Avg Cost/Claim
$118
National Cost Distribution
How much do providers bill per claim for J2545? Based on 5 providers billing this code nationally.
Median
$140.38
Average
$155.95
Std Dev
$115.82
Max
$346.69
Percentile Distribution (Cost per Claim)
50% of providers bill between $111.45 and $147.72 per claim for this code.
90% bill between $64.70 and $267.10.
Top 1% bill above $338.73.
About This Procedure
HCPCS code J2545 was billed by 6 providers across 1,211 claims, totaling $143K in Medicaid payments from 2018–2024. This code was used for 1,031 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
$140.38
Providers Billing
5
National Spending
$143K
Avg/Median Ratio
1.11×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for J2545
| # | Provider | Total Paid |
|---|---|---|
| 1 | Children's Hospital Of Wisconsin, Inc. Milwaukee, WI · Dentist, Pediatric Dentistry | $106K |
| 2 | Virginia Commonwealth University Health System Authority Richmond, VA · General Acute Care Hospital | $21K |
| 3 | Arkansas Childrens Hospital Little Rock, AR · Clinic/Center, Critical Access Hospital | $12K |
| 4 | 1548315401 | $3K |
| 5 | Memorial Hospital For Cancer And Allied Diseases New York, NY · Pharmacy | $1K |
| 6 | 1346297843 | $0 |
Showing top 6 of 6 providers billing this code