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

#8226 of 11K

J3230

HCPCS Procedure Code

HCPCS code J3230 is the #8,226 most-billed Medicaid procedure code, with $5K in payments across 502 claims from 2018–2024. The national median cost per claim is $12.61.

Total Paid

$5K

0.00% of all spending

Total Claims

502

Providers

9

Avg Cost/Claim

$9

National Cost Distribution

How much do providers bill per claim for J3230? Based on 6 providers billing this code nationally.

Median

$12.61

Average

$12.51

Std Dev

$6.71

Max

$24.19

Percentile Distribution (Cost per Claim)

p10
$5.96
p25
$7.76
Median
$12.61
p75
$13.64
p90
$18.96
p95
$21.58
p99
$23.67

50% of providers bill between $7.76 and $13.64 per claim for this code.

90% bill between $5.96 and $18.96.

Top 1% bill above $23.67.

About This Procedure

HCPCS code J3230 was billed by 9 providers across 502 claims, totaling $5K in Medicaid payments from 2018–2024. This code was used for 428 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

$12.61

Providers Billing

6

National Spending

$5K

Avg/Median Ratio

0.99×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for J3230

#ProviderTotal Paid
11447230388$3K
2New York City Health And Hospitals Corporation

Bronx, NY · Internal Medicine

$486
3Kennedy University Hospital Inc.

Stratford, NJ · General Acute Care Hospital

$435
41891892741$387
51770586794$154
6New York City Health And Hospitals Corporation

Elmhurst, NY · Internal Medicine

$96
71770674350$0
81144210253$0
91538245634$0

Showing top 9 of 9 providers billing this code

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