J3535
HCPCS Procedure Code
HCPCS code J3535 is the #2,759 most-billed Medicaid procedure code, with $3.8M in payments across 181K claims from 2018–2024. The national median cost per claim is $3.68. Costs vary widely — the 90th percentile is $37.86 per claim, 10.3× the median.
Total Paid
$3.8M
0.00% of all spending
Total Claims
181K
Providers
189
Avg Cost/Claim
$21
National Cost Distribution
How much do providers bill per claim for J3535? Based on 135 providers billing this code nationally.
Median
$3.68
Average
$12.13
Std Dev
$20.48
Max
$152.61
Percentile Distribution (Cost per Claim)
50% of providers bill between $0.91 and $15.54 per claim for this code.
90% bill between $0.15 and $37.86.
Top 1% bill above $94.34.
About This Procedure
HCPCS code J3535 was billed by 189 providers across 181K claims, totaling $3.8M in Medicaid payments from 2018–2024. This code was used for 150K 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
$3.68
Providers Billing
135
National Spending
$3.8M
Avg/Median Ratio
3.30×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for J3535
| # | Provider | Total Paid |
|---|---|---|
| 1 | Children's Hospital Medical Center Cincinnati, OH · Clinic/Center, Primary Care | $839K |
| 2 | Childrens Hospital Of The Kings Daughters Inc Norfolk, VA · Social Worker, Clinical | $703K |
| 3 | Nationwide Children's Hospital Columbus, OH · General Acute Care Hospital | $535K |
| 4 | Childrens Hospital Of Philadelphia Philadelphia, PA · General Acute Care Hospital Children | $481K |
| 5 | The Nemours Foundation Orlando, FL · General Acute Care Hospital Children | $261K |
| 6 | 1346297843 | $232K |
| 7 | Montefiore Medical Center Bronx, NY · General Acute Care Hospital | $204K |
| 8 | 1518042175 | $58K |
| 9 | Nyu Langone Hospitals New York, NY · Clinic/Center, Oncology | $58K |
| 10 | 1952348047 | $41K |
| 11 | The Nemours Foundation Wilmington, DE · General Acute Care Hospital Children | $39K |
| 12 | Ohiohealth Corporation Columbus, OH · General Acute Care Hospital | $37K |
| 13 | 1427616002 | $36K |
| 14 | 1720537178 | $30K |
| 15 | University Hospitals Cleveland Medical Center Cleveland, OH · General Acute Care Hospital | $26K |
| 16 | Cooperman Barnabas Medical Center Inc Livingston, NJ · General Acute Care Hospital | $22K |
| 17 | Ohiohealth Corporation Columbus, OH · General Acute Care Hospital | $15K |
| 18 | 1972535052 | $15K |
| 19 | 1356307581 | $14K |
| 20 | 1578597993 | $11K |
Showing top 20 of 189 providers billing this code