J2790
HCPCS Procedure Code
HCPCS code J2790 is the #4,330 most-billed Medicaid procedure code, with $657K in payments across 15K claims from 2018–2024. The national median cost per claim is $61.58.
Total Paid
$657K
0.00% of all spending
Total Claims
15K
Providers
107
Avg Cost/Claim
$43
National Cost Distribution
How much do providers bill per claim for J2790? Based on 86 providers billing this code nationally.
Median
$61.58
Average
$58.04
Std Dev
$34.60
Max
$156.52
Percentile Distribution (Cost per Claim)
50% of providers bill between $29.92 and $76.81 per claim for this code.
90% bill between $11.71 and $95.90.
Top 1% bill above $151.59.
About This Procedure
HCPCS code J2790 was billed by 107 providers across 15K claims, totaling $657K in Medicaid payments from 2018–2024. This code was used for 14K 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
$61.58
Providers Billing
86
National Spending
$657K
Avg/Median Ratio
0.94×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for J2790
| # | Provider | Total Paid |
|---|---|---|
| 1 | St Elizabeth Medical Center, Inc Edgewood, KY · Portable X-Ray and/or Other Portable Diagnostic Imaging Supplier | $109K |
| 2 | The New York And Presbyterian Hospital New York, NY · General Acute Care Hospital | $79K |
| 3 | Montefiore Medical Center Bronx, NY · General Acute Care Hospital | $44K |
| 4 | Pikeville Medical Center Inc Pikeville, KY · General Acute Care Hospital | $25K |
| 5 | 1790868982 | $25K |
| 6 | 1295842615 | $23K |
| 7 | Spectrum Health Primary Care Partners Grand Rapids, MI · Psychologist, Clinical Child & Adolescent | $21K |
| 8 | 1770581894 | $20K |
| 9 | Baystate Medical Center Inc Springfield, MA · General Acute Care Hospital | $20K |
| 10 | The Metrohealth System Cleveland, OH · General Acute Care Hospital | $20K |
| 11 | Umass Memorial Medical Center, Inc. Worcester, MA · General Acute Care Hospital | $18K |
| 12 | 1922448836 | $16K |
| 13 | Rector & Visitors Of The University Of Virginia Charlottesville, VA · General Acute Care Hospital | $16K |
| 14 | Procare Pharmacy Direct, Llc. Monroeville, PA · Pharmacy, Community/Retail Pharmacy | $14K |
| 15 | 1598868655 | $11K |
| 16 | 1003811381 | $11K |
| 17 | The Lowell General Hospital Lowell, MA · Pharmacy, Institutional Pharmacy | $10K |
| 18 | 1417959701 | $10K |
| 19 | 1730136680 | $10K |
| 20 | 1457389249 | $10K |
Showing top 20 of 107 providers billing this code