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

#3085 of 11K

J2550

HCPCS Procedure Code

HCPCS code J2550 is the #3,085 most-billed Medicaid procedure code, with $2.5M in payments across 962K claims from 2018–2024. The national median cost per claim is $1.00. Costs vary widely — the 90th percentile is $7.43 per claim, 7.4× the median.

Total Paid

$2.5M

0.00% of all spending

Total Claims

962K

Providers

1,288

Avg Cost/Claim

$3

National Cost Distribution

How much do providers bill per claim for J2550? Based on 1,015 providers billing this code nationally.

Median

$1.00

Average

$4.28

Std Dev

$17.36

Max

$350.37

Percentile Distribution (Cost per Claim)

p10
$0.03
p25
$0.21
Median
$1.00
p75
$2.72
p90
$7.43
p95
$11.63
p99
$61.42

50% of providers bill between $0.21 and $2.72 per claim for this code.

90% bill between $0.03 and $7.43.

Top 1% bill above $61.42.

About This Procedure

HCPCS code J2550 was billed by 1,288 providers across 962K claims, totaling $2.5M in Medicaid payments from 2018–2024. This code was used for 717K 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

$1.00

Providers Billing

1,015

National Spending

$2.5M

Avg/Median Ratio

4.28×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for J2550

#ProviderTotal Paid
1Charleston Area Medical Center Inc

Charleston, WV · General Acute Care Hospital

$258K
21366481632$158K
31871556217$151K
41437622933$69K
51184606600$59K
61851309595$59K
71255336517$48K
81013950054$46K
91275528614$43K
101639124142$41K
111558313213$38K
121720537178$36K
131043293608$33K
14Bluefield Hospital Company Llc

Bluefield, WV · General Acute Care Hospital

$32K
151891722377$31K
161285733790$28K
171538141627$27K
181063484483$27K
191619038247$26K
201922032424$26K

Showing top 20 of 1,288 providers billing this code