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

#4425 of 11K

J2919

HCPCS Procedure Code

HCPCS code J2919 is the #4,425 most-billed Medicaid procedure code, with $598K in payments across 219K claims from 2018–2024. The national median cost per claim is $1.77. Costs vary widely — the 90th percentile is $12.04 per claim, 6.8× the median.

Total Paid

$598K

0.00% of all spending

Total Claims

219K

Providers

1K

Avg Cost/Claim

$3

National Cost Distribution

How much do providers bill per claim for J2919? Based on 862 providers billing this code nationally.

Median

$1.77

Average

$5.93

Std Dev

$22.41

Max

$583.42

Percentile Distribution (Cost per Claim)

p10
$0.11
p25
$0.39
Median
$1.77
p75
$5.81
p90
$12.04
p95
$19.38
p99
$60.93

50% of providers bill between $0.39 and $5.81 per claim for this code.

90% bill between $0.11 and $12.04.

Top 1% bill above $60.93.

About This Procedure

HCPCS code J2919 was billed by 1K providers across 219K claims, totaling $598K in Medicaid payments from 2018–2024. This code was used for 170K 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

$1.77

Providers Billing

862

National Spending

$598K

Avg/Median Ratio

3.35×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for J2919

#ProviderTotal Paid
1Pikeville Medical Center Inc

Pikeville, KY · General Acute Care Hospital

$23K
2Vhs Childrens Hospital Of Michigan Inc

Detroit, MI · Clinic/Center, Ambulatory Surgical

$22K
3Stanford Health Care

Stanford, CA · General Acute Care Hospital

$20K
41780614685$13K
5Norton Hospitals, Inc

Louisville, KY · General Acute Care Hospital

$10K
6Rhode Island Hospital

Providence, RI · General Acute Care Hospital

$10K
7Seventh-day Adventists Loma Linda University Medical Center

Loma Linda, CA · General Acute Care Hospital

$10K
8North Carolina Baptist Hospital

Winston Salem, NC · General Acute Care Hospital

$9K
91518018191$8K
10Uofl Health-louisville Inc

Louisville, KY · Psychiatric Hospital

$8K
111295181477$7K
121639523004$7K
13Long Island Jewish Medical Center

New Hyde Park, NY · General Acute Care Hospital

$6K
14Egleston Children's Hospital At Emory University Inc.

Atlanta, GA · Pediatrics Pediatric Emergency Medicine

$6K
151316938301$6K
161811080526$6K
171437230034$5K
181689744450$5K
191609869916$5K
20Hmh Hospitals Corporation

Hackensack, NJ · Ambulance

$5K

Showing top 20 of 1K providers billing this code

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