J2796
HCPCS Procedure Code
HCPCS code J2796 is the #2,700 most-billed Medicaid procedure code, with $4.1M in payments across 5K claims from 2018–2024. The national median cost per claim is $800.92.
Total Paid
$4.1M
0.00% of all spending
Total Claims
5K
Providers
7
Avg Cost/Claim
$738
National Cost Distribution
How much do providers bill per claim for J2796? Based on 7 providers billing this code nationally.
Median
$800.92
Average
$855.07
Std Dev
$665.96
Max
$2,128.65
Percentile Distribution (Cost per Claim)
50% of providers bill between $438.99 and $1,029.13 per claim for this code.
90% bill between $305.51 and $1,594.97.
Top 1% bill above $2,075.28.
About This Procedure
HCPCS code J2796 was billed by 7 providers across 5K claims, totaling $4.1M 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
$800.92
Providers Billing
7
National Spending
$4.1M
Avg/Median Ratio
1.07×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for J2796
| # | Provider | Total Paid |
|---|---|---|
| 1 | Dana-farber Cancer Institute, Inc. Boston, MA · General Acute Care Hospital | $2.9M |
| 2 | Memorial Hospital For Cancer And Allied Diseases New York, NY · Pharmacy | $650K |
| 3 | Yale New Haven Hospital New Haven, CT · General Acute Care Hospital | $222K |
| 4 | The General Hospital Corporation Boston, MA · General Acute Care Hospital | $141K |
| 5 | Mount Sinai Hospital New York, NY · Ambulance | $55K |
| 6 | Regents Of The University Of California San Diego, CA · General Acute Care Hospital | $53K |
| 7 | County Of Santa Clara San Jose, CA · Case Manager/Care Coordinator | $20K |
Showing top 7 of 7 providers billing this code