J3475
HCPCS Procedure Code
HCPCS code J3475 is the #2,639 most-billed Medicaid procedure code, with $4.4M in payments across 1.6M claims from 2018–2024. The national median cost per claim is $1.03. Costs vary widely — the 90th percentile is $9.65 per claim, 9.4× the median.
Total Paid
$4.4M
0.00% of all spending
Total Claims
1.6M
Providers
2K
Avg Cost/Claim
$3
National Cost Distribution
How much do providers bill per claim for J3475? Based on 1K providers billing this code nationally.
Median
$1.03
Average
$5.04
Std Dev
$28.63
Max
$708.69
Percentile Distribution (Cost per Claim)
50% of providers bill between $0.16 and $3.75 per claim for this code.
90% bill between $0.03 and $9.65.
Top 1% bill above $33.91.
About This Procedure
HCPCS code J3475 was billed by 2K providers across 1.6M claims, totaling $4.4M in Medicaid payments from 2018–2024. This code was used for 1.2M 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
$1.03
Providers Billing
1K
National Spending
$4.4M
Avg/Median Ratio
4.89×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for J3475
| # | Provider | Total Paid |
|---|---|---|
| 1 | Rhode Island Hospital Providence, RI · General Acute Care Hospital | $356K |
| 2 | University Of Utah Salt Lake City, UT · Clinic/Center, Dental | $242K |
| 3 | 1306871223 | $204K |
| 4 | 1265423917 | $104K |
| 5 | Regents Of The University Of California Sacramento, CA · General Acute Care Hospital | $73K |
| 6 | Uofl Health-louisville Inc Louisville, KY · Psychiatric Hospital | $73K |
| 7 | Owensboro Health Inc Owensboro, KY · General Acute Care Hospital | $70K |
| 8 | 1679660617 | $69K |
| 9 | 1417975061 | $68K |
| 10 | 1285687749 | $67K |
| 11 | Seventh-day Adventists Loma Linda University Medical Center Loma Linda, CA · General Acute Care Hospital | $61K |
| 12 | University Of Kentucky Lexington, KY · General Acute Care Hospital | $54K |
| 13 | West Virginia University Hospitals, Inc Morgantown, WV · Clinical Medical Laboratory | $52K |
| 14 | The General Hospital Corporation Boston, MA · General Acute Care Hospital | $46K |
| 15 | Charleston Area Medical Center Inc Charleston, WV · General Acute Care Hospital | $46K |
| 16 | Virginia Commonwealth University Health System Authority Richmond, VA · General Acute Care Hospital | $42K |
| 17 | Stanford Health Care Stanford, CA · General Acute Care Hospital | $40K |
| 18 | Unm Hospital Albuquerque, NM · General Acute Care Hospital | $36K |
| 19 | 1184606600 | $35K |
| 20 | University Medical Center, Inc Louisville, KY · Student in an Organized Health Care Education/Training Program | $34K |
Showing top 20 of 2K providers billing this code