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

#6409 of 11K

J2788

HCPCS Procedure Code

HCPCS code J2788 is the #6,409 most-billed Medicaid procedure code, with $68K in payments across 2K claims from 2018–2024. The national median cost per claim is $26.98.

Total Paid

$68K

0.00% of all spending

Total Claims

2K

Providers

11

Avg Cost/Claim

$30

National Cost Distribution

How much do providers bill per claim for J2788? Based on 11 providers billing this code nationally.

Median

$26.98

Average

$25.24

Std Dev

$7.25

Max

$38.10

Percentile Distribution (Cost per Claim)

p10
$18.75
p25
$21.60
Median
$26.98
p75
$28.88
p90
$30.05
p95
$34.07
p99
$37.30

50% of providers bill between $21.60 and $28.88 per claim for this code.

90% bill between $18.75 and $30.05.

Top 1% bill above $37.30.

About This Procedure

HCPCS code J2788 was billed by 11 providers across 2K claims, totaling $68K in Medicaid payments from 2018–2024. This code was used for 2K 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

$26.98

Providers Billing

11

National Spending

$68K

Avg/Median Ratio

0.94×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for J2788

#ProviderTotal Paid
11306909957$25K
21821095779$22K
31972556942$7K
41033553847$3K
51417959701$3K
61326048182$2K
71881755601$2K
81245415314$2K
91437282464$344
101073679254$294
111285701672$134

Showing top 11 of 11 providers billing this code