J2560
HCPCS Procedure Code
HCPCS code J2560 is the #4,502 most-billed Medicaid procedure code, with $545K in payments across 23K claims from 2018–2024. The national median cost per claim is $34.60. Costs vary widely — the 90th percentile is $134.23 per claim, 3.9× the median.
Total Paid
$545K
0.00% of all spending
Total Claims
23K
Providers
56
Avg Cost/Claim
$24
National Cost Distribution
How much do providers bill per claim for J2560? Based on 45 providers billing this code nationally.
Median
$34.60
Average
$57.32
Std Dev
$65.36
Max
$277.51
Percentile Distribution (Cost per Claim)
50% of providers bill between $11.57 and $76.63 per claim for this code.
90% bill between $1.53 and $134.23.
Top 1% bill above $271.79.
About This Procedure
HCPCS code J2560 was billed by 56 providers across 23K claims, totaling $545K in Medicaid payments from 2018–2024. This code was used for 17K 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
$34.60
Providers Billing
45
National Spending
$545K
Avg/Median Ratio
1.66×
Moderately skewed
Top Providers Billing This Code
Ranked by total Medicaid payments for J2560
| # | Provider | Total Paid |
|---|---|---|
| 1 | Alameda Health System Oakland, CA · General Acute Care Hospital | $108K |
| 2 | Unm Hospital Albuquerque, NM · General Acute Care Hospital | $107K |
| 3 | 1427123132 | $102K |
| 4 | Providence Health & Services Washington Anchorage, AK · General Acute Care Hospital | $35K |
| 5 | Presbyterian Healthcare Services Albuquerque, NM · Emergency Medicine | $26K |
| 6 | Regents Of The University Of California San Diego, CA · General Acute Care Hospital | $17K |
| 7 | University Medical Center, Inc Louisville, KY · Student in an Organized Health Care Education/Training Program | $16K |
| 8 | 1285845982 | $15K |
| 9 | 1699986331 | $15K |
| 10 | Yukon-kuskokwim Health Corporation Bethel, AK · General Acute Care Hospital Rural | $11K |
| 11 | 1659359446 | $10K |
| 12 | 1649556200 | $8K |
| 13 | 1811946734 | $5K |
| 14 | City & County Of San Francisco San Francisco, CA · Case Manager/Care Coordinator | $5K |
| 15 | County Of Santa Clara San Jose, CA · Case Manager/Care Coordinator | $5K |
| 16 | 1154307593 | $5K |
| 17 | San Juan Regional Medical Center, Inc. Farmington, NM · Audiologist | $4K |
| 18 | 1720084999 | $4K |
| 19 | 1811941883 | $4K |
| 20 | 1538131214 | $4K |
Showing top 20 of 56 providers billing this code