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

#1051 of 11K

J2704

HCPCS Procedure Code

HCPCS code J2704 is the #1,051 most-billed Medicaid procedure code, with $45.8M in payments across 12.8M claims from 2018–2024. The national median cost per claim is $0.76. Costs vary widely — the 90th percentile is $12.85 per claim, 16.9× the median.

Total Paid

$45.8M

0.00% of all spending

Total Claims

12.8M

Providers

3K

Avg Cost/Claim

$4

National Cost Distribution

How much do providers bill per claim for J2704? Based on 3K providers billing this code nationally.

Median

$0.76

Average

$5.69

Std Dev

$17.90

Max

$260.04

Percentile Distribution (Cost per Claim)

p10
$0.01
p25
$0.08
Median
$0.76
p75
$4.22
p90
$12.85
p95
$24.26
p99
$73.75

50% of providers bill between $0.08 and $4.22 per claim for this code.

90% bill between $0.01 and $12.85.

Top 1% bill above $73.75.

About This Procedure

HCPCS code J2704 was billed by 3K providers across 12.8M claims, totaling $45.8M in Medicaid payments from 2018–2024. This code was used for 10.1M 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

$0.76

Providers Billing

3K

National Spending

$45.8M

Avg/Median Ratio

7.49×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for J2704

#ProviderTotal Paid
1University Of Utah

Salt Lake City, UT · Clinic/Center, Dental

$3.4M
2The Nemours Foundation

Orlando, FL · General Acute Care Hospital Children

$2.1M
3Charleston Area Medical Center Inc

Charleston, WV · General Acute Care Hospital

$2.0M
4Rhode Island Hospital

Providence, RI · General Acute Care Hospital

$1.9M
5Scottish Rite Children's Medical Center

Atlanta, GA · Pediatrics Pediatric Hematology-Oncology

$1.1M
61073518007$915K
71104856095$914K
81073674040$669K
9The Miriam Hospital

Providence, RI · General Acute Care Hospital

$651K
10Seventh-day Adventists Loma Linda University Medical Center

Loma Linda, CA · General Acute Care Hospital

$612K
11Children's Hospital Corporation

Boston, MA · Clinic/Center

$565K
121750332565$542K
13Uofl Health-louisville Inc

Louisville, KY · Psychiatric Hospital

$437K
141386643294$418K
151871556217$396K
16St. Mary's Medical Center Inc

Huntington, WV · General Acute Care Hospital

$373K
17Egleston Children's Hospital At Emory University Inc.

Atlanta, GA · Pediatrics Pediatric Emergency Medicine

$369K
18The Cooper Health System

Camden, NJ · General Acute Care Hospital

$350K
191134152549$349K
201891900635$334K

Showing top 20 of 3K providers billing this code

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