J3260
HCPCS Procedure Code
HCPCS code J3260 is the #5,814 most-billed Medicaid procedure code, with $134K in payments across 7K claims from 2018–2024. The national median cost per claim is $3.95. Costs vary widely — the 90th percentile is $17.84 per claim, 4.5× the median.
Total Paid
$134K
0.00% of all spending
Total Claims
7K
Providers
38
Avg Cost/Claim
$18
National Cost Distribution
How much do providers bill per claim for J3260? Based on 17 providers billing this code nationally.
Median
$3.95
Average
$11.99
Std Dev
$25.04
Max
$105.65
Percentile Distribution (Cost per Claim)
50% of providers bill between $1.58 and $16.93 per claim for this code.
90% bill between $0.32 and $17.84.
Top 1% bill above $91.60.
About This Procedure
HCPCS code J3260 was billed by 38 providers across 7K claims, totaling $134K in Medicaid payments from 2018–2024. This code was used for 6K 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
$3.95
Providers Billing
17
National Spending
$134K
Avg/Median Ratio
3.04×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for J3260
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1932266632 | $118K |
| 2 | 1700277647 | $3K |
| 3 | The Metrohealth System Cleveland, OH · General Acute Care Hospital | $3K |
| 4 | University Hospitals Cleveland Medical Center Cleveland, OH · General Acute Care Hospital | $3K |
| 5 | 1538141627 | $2K |
| 6 | 1861422941 | $2K |
| 7 | 1588663769 | $1K |
| 8 | Arthur G James Cancer Hospital And Research Institute Columbus, OH · Special Hospital | $499 |
| 9 | Sharp Chula Vista Medical Center Chula Vista, CA · General Acute Care Hospital | $280 |
| 10 | 1740840537 | $159 |
| 11 | 1295748960 | $137 |
| 12 | 1184606600 | $65 |
| 13 | 1932208576 | $63 |
| 14 | 1346338381 | $35 |
| 15 | Ohio State University Hospitals Columbus, OH · General Acute Care Hospital | $23 |
| 16 | 1710491253 | $4 |
| 17 | Mainehealth Portland, ME · Emergency Medicine | $3 |
| 18 | 1083655997 | $0 |
| 19 | Hartford Hospital Hartford, CT · General Acute Care Hospital | $0 |
| 20 | 1801887658 | $0 |
Showing top 20 of 38 providers billing this code