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

#2425 of 11K

J3241

HCPCS Procedure Code

HCPCS code J3241 is the #2,425 most-billed Medicaid procedure code, with $5.9M in payments across 370 claims from 2018–2024. The national median cost per claim is $20,286.67.

Total Paid

$5.9M

0.00% of all spending

Total Claims

370

Providers

3

Avg Cost/Claim

$16K

National Cost Distribution

How much do providers bill per claim for J3241? Based on 3 providers billing this code nationally.

Median

$20,286.67

Average

$21,838.62

Std Dev

$19,922.47

Max

$42,491.68

Percentile Distribution (Cost per Claim)

p10
$6,247.35
p25
$11,512.10
Median
$20,286.67
p75
$31,389.18
p90
$38,050.68
p95
$40,271.18
p99
$42,047.58

50% of providers bill between $11,512.10 and $31,389.18 per claim for this code.

90% bill between $6,247.35 and $38,050.68.

Top 1% bill above $42,047.58.

About This Procedure

HCPCS code J3241 was billed by 3 providers across 370 claims, totaling $5.9M in Medicaid payments from 2018–2024. This code was used for 138 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

$20,286.67

Providers Billing

3

National Spending

$5.9M

Avg/Median Ratio

1.08×

Normal distribution

Provider Coverage

We have 3 providers billing this code in our dataset. Individual provider breakdowns are available for top-spending procedure codes.