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

#1055 of 11K

J3010

HCPCS Procedure Code

HCPCS code J3010 is the #1,055 most-billed Medicaid procedure code, with $45.4M in payments across 12.7M claims from 2018–2024. The national median cost per claim is $0.55. Costs vary widely — the 90th percentile is $7.30 per claim, 13.3× the median.

Total Paid

$45.4M

0.00% of all spending

Total Claims

12.7M

Providers

3K

Avg Cost/Claim

$4

National Cost Distribution

How much do providers bill per claim for J3010? Based on 3K providers billing this code nationally.

Median

$0.55

Average

$4.28

Std Dev

$23.30

Max

$764.96

Percentile Distribution (Cost per Claim)

p10
$0.01
p25
$0.07
Median
$0.55
p75
$2.72
p90
$7.30
p95
$12.97
p99
$53.01

50% of providers bill between $0.07 and $2.72 per claim for this code.

90% bill between $0.01 and $7.30.

Top 1% bill above $53.01.

About This Procedure

HCPCS code J3010 was billed by 3K providers across 12.7M claims, totaling $45.4M in Medicaid payments from 2018–2024. This code was used for 10.4M 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

$0.55

Providers Billing

3K

National Spending

$45.4M

Avg/Median Ratio

7.78×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for J3010

#ProviderTotal Paid
1The Nemours Foundation

Orlando, FL · General Acute Care Hospital Children

$14.1M
2Charleston Area Medical Center Inc

Charleston, WV · General Acute Care Hospital

$2.6M
3Rhode Island Hospital

Providence, RI · General Acute Care Hospital

$1.6M
4The Miriam Hospital

Providence, RI · General Acute Care Hospital

$896K
51477584993$839K
61073518007$721K
7Seventh-day Adventists Loma Linda University Medical Center

Loma Linda, CA · General Acute Care Hospital

$708K
81386643294$537K
91639124142$401K
101871556217$348K
11Children's Health System Of Texas

Dallas, TX · General Acute Care Hospital Children

$316K
121336243393$285K
13St. Mary's Medical Center Inc

Huntington, WV · General Acute Care Hospital

$284K
141750332565$276K
151013332014$275K
161619964806$267K
171558313213$250K
18Uofl Health-louisville Inc

Louisville, KY · Psychiatric Hospital

$248K
19Boston Medical Center Corporation

Boston, MA · General Acute Care Hospital

$242K
201104856095$230K

Showing top 20 of 3K providers billing this code