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

#7258 of 11K

J3250

HCPCS Procedure Code

HCPCS code J3250 is the #7,258 most-billed Medicaid procedure code, with $23K in payments across 3K claims from 2018–2024. The national median cost per claim is $6.17. Costs vary widely — the 90th percentile is $16.66 per claim, 2.7× the median.

Total Paid

$23K

0.00% of all spending

Total Claims

3K

Providers

23

Avg Cost/Claim

$7

National Cost Distribution

How much do providers bill per claim for J3250? Based on 11 providers billing this code nationally.

Median

$6.17

Average

$9.52

Std Dev

$10.82

Max

$38.52

Percentile Distribution (Cost per Claim)

p10
$0.13
p25
$3.63
Median
$6.17
p75
$10.86
p90
$16.66
p95
$27.59
p99
$36.33

50% of providers bill between $3.63 and $10.86 per claim for this code.

90% bill between $0.13 and $16.66.

Top 1% bill above $36.33.

About This Procedure

HCPCS code J3250 was billed by 23 providers across 3K claims, totaling $23K in Medicaid payments from 2018–2024. This code was used for 3K 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

$6.17

Providers Billing

11

National Spending

$23K

Avg/Median Ratio

1.54×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for J3250

#ProviderTotal Paid
11710073390$15K
2Nyu Langone Hospitals

New York, NY · Clinic/Center, Oncology

$6K
31821185398$963
4Kennedy University Hospital Inc.

Stratford, NJ · General Acute Care Hospital

$521
5St Josephs University Medical Center Inc.

Paterson, NJ · General Acute Care Hospital

$506
6The Metrohealth System

Cleveland, OH · General Acute Care Hospital

$349
71396831269$178
81548296106$91
9The Cooper Health System

Camden, NJ · General Acute Care Hospital

$72
10Rector & Visitors Of The University Of Virginia

Charlottesville, VA · General Acute Care Hospital

$36
11Regents Of The University Of Michigan

Ann Arbor, MI · Clinic/Center, End-Stage Renal Disease (ESRD) Treatment

$4
12Temple University Hospital Inc

Philadelphia, PA · General Acute Care Hospital

$0
13Aurora Health Care Metro, Inc.

Milwaukee, WI · Internal Medicine, Hematology & Oncology

$0
141568727048$0
151376564088$0
161487865184$0
171588656946$0
18Henry Ford Health St. John Hospital

Chicago, IL · Clinic/Center, Ambulatory Surgical

$0
19Trustees Of The University Of Pennsylvania

Philadelphia, PA · Community/Behavioral Health

$0
201780658443$0

Showing top 20 of 23 providers billing this code