#7047 of 11K

J3410

HCPCS Procedure Code

HCPCS code J3410 is the #7,047 most-billed Medicaid procedure code, with $30K in payments across 2K claims from 2018–2024. The national median cost per claim is $4.51. Costs vary widely — the 90th percentile is $32.28 per claim, 7.2× the median.

Total Paid

$30K

0.00% of all spending

Total Claims

Providers

Avg Cost/Claim

$14

National Cost Distribution

How much do providers bill per claim for J3410? Based on 20 providers billing this code nationally.

Median

$4.51

Average

$12.23

Std Dev

$15.60

Max

$59.46

Percentile Distribution (Cost per Claim)

p10

$0.26

p25

$2.43

Median

$4.51

p75

$13.97

p90

$32.28

p95

$34.90

p99

$54.55

50% of providers bill between $2.43 and $13.97 per claim for this code.

90% bill between $0.26 and $32.28.

Top 1% bill above $54.55.

About This Procedure

HCPCS code J3410 was billed by 31 providers across 2K claims, totaling $30K in Medicaid payments from 2018–2024. This code was used for 2K 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

$4.51

Providers Billing

National Spending

$30K

Avg/Median Ratio

2.71×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for J3410

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1184373268	$11K	$59.46	13.2× median	Top 1%
2	1114921160	$10K	$30.83	6.8× median	Above 75th
3	1093719932	$5K	$33.60	7.5× median	Top 10%
4	Sharp Memorial Hospital San Diego, CA · General Acute Care Hospital, Women	$1K	$19.75	4.4× median	Above 75th
5	1457392904	$794	$11.34	2.5× median	Above Median
6	1780196345	$516	$4.45	1.0× median	Below Median
7	1710958228	$482	$32.13	7.1× median	Above 75th
8	1447280300	$430	$2.88	0.6× median	Below Median
9	1114367497	$304	$10.85	2.4× median	Above Median
10	1386697977	$204	$3.10	0.7× median	Below Median
11	1285607416	$193	$12.04	2.7× median	Above Median
12	1548296106	$145	$3.31	0.7× median	Below Median
13	Miami Valley Hospital Dayton, OH · General Acute Care Hospital	$134	$0.51	0.1× median	Below Median
14	1043241821	$129	$9.96	2.2× median	Above Median
15	1609869916	$68	$4.56	1.0× median	Above Median
16	1891892741	$55	$4.25	0.9× median	Below Median
17	Phoenix Children's Hospital Phoenix, AZ · General Acute Care Hospital Children	$44	$0.27	0.1× median	Below Median
18	Memorial Hospital For Cancer And Allied Diseases New York, NY · Pharmacy	$29	$1.05	0.2× median	Below Median
19	Dayton Osteopathic Hospital Dayton, OH · General Acute Care Hospital	$14	$0.17	0.0× median	Below Median
20	1942288527	$1	$0.06	0.0× median	Below Median

Showing top 20 of 31 providers billing this code

Related Procedures

J3420Injection, vitamin B-12 cyanocobalamin, up to one thousand mcg$4.4M J3411$320K J3415$225K

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