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

#3885 of 11K

J3031

HCPCS Procedure Code

HCPCS code J3031 is the #3,885 most-billed Medicaid procedure code, with $1.1M in payments across 1K claims from 2018–2024. The national median cost per claim is $655.12.

Total Paid

$1.1M

0.00% of all spending

Total Claims

1K

Providers

2

Avg Cost/Claim

$704

National Cost Distribution

How much do providers bill per claim for J3031? Based on 2 providers billing this code nationally.

Median

$655.12

Average

$655.12

Std Dev

$73.14

Max

$706.84

Percentile Distribution (Cost per Claim)

p10
$613.75
p25
$629.26
Median
$655.12
p75
$680.98
p90
$696.50
p95
$701.67
p99
$705.81

50% of providers bill between $629.26 and $680.98 per claim for this code.

90% bill between $613.75 and $696.50.

Top 1% bill above $705.81.

About This Procedure

HCPCS code J3031 was billed by 2 providers across 1K claims, totaling $1.1M in Medicaid payments from 2018–2024. This code was used for 1K 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

$655.12

Providers Billing

2

National Spending

$1.1M

Avg/Median Ratio

1.00×

Normal distribution

Provider Coverage

We have 2 providers billing this code in our dataset. Individual provider breakdowns are available for top-spending procedure codes.