J3471
HCPCS Procedure Code
HCPCS code J3471 is the #5,501 most-billed Medicaid procedure code, with $186K in payments across 7K claims from 2018–2024. The national median cost per claim is $32.68. Costs vary widely — the 90th percentile is $69.15 per claim, 2.1× the median.
Total Paid
$186K
0.00% of all spending
Total Claims
7K
Providers
22
Avg Cost/Claim
$25
National Cost Distribution
How much do providers bill per claim for J3471? Based on 16 providers billing this code nationally.
Median
$32.68
Average
$41.64
Std Dev
$51.35
Max
$216.94
Percentile Distribution (Cost per Claim)
50% of providers bill between $12.95 and $43.65 per claim for this code.
90% bill between $5.34 and $69.15.
Top 1% bill above $195.79.
About This Procedure
HCPCS code J3471 was billed by 22 providers across 7K claims, totaling $186K 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
$32.68
Providers Billing
16
National Spending
$186K
Avg/Median Ratio
1.27×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for J3471
| # | Provider | Total Paid |
|---|---|---|
| 1 | Boston Medical Center Corporation Boston, MA · General Acute Care Hospital | $60K |
| 2 | West Virginia University Hospitals, Inc Morgantown, WV · Clinical Medical Laboratory | $46K |
| 3 | Aurora Health Care Metro, Inc. Milwaukee, WI · Internal Medicine, Hematology & Oncology | $31K |
| 4 | Froedtert Memorial Lutheran Hospital, Inc. Milwaukee, WI · Clinic/Center, Radiology | $20K |
| 5 | The Metrohealth System Cleveland, OH · General Acute Care Hospital | $11K |
| 6 | 1245251222 | $5K |
| 7 | Miami Valley Hospital Dayton, OH · General Acute Care Hospital | $3K |
| 8 | 1699874248 | $3K |
| 9 | Rector & Visitors Of The University Of Virginia Charlottesville, VA · General Acute Care Hospital | $3K |
| 10 | New York City Health And Hospitals Corporation Jamaica, NY · General Acute Care Hospital | $2K |
| 11 | Riverside Hospital Inc Newport News, VA · Psychiatric Hospital | $991 |
| 12 | 1235196510 | $501 |
| 13 | Beth Israel Deaconess Medical Center, Inc. Boston, MA · General Acute Care Hospital | $486 |
| 14 | 1245248939 | $396 |
| 15 | 1043240682 | $111 |
| 16 | Sharp Chula Vista Medical Center Chula Vista, CA · General Acute Care Hospital | $96 |
| 17 | Yale New Haven Hospital New Haven, CT · General Acute Care Hospital | $0 |
| 18 | 1639143381 | $0 |
| 19 | County Of Santa Clara San Jose, CA · Case Manager/Care Coordinator | $0 |
| 20 | Dallas County Hospital District Dallas, TX · Clinic/Center, Ambulatory Surgical | $0 |
Showing top 20 of 22 providers billing this code