J7070
HCPCS Procedure Code
HCPCS code J7070 is the #5,727 most-billed Medicaid procedure code, with $148K in payments across 85K claims from 2018–2024. The national median cost per claim is $1.57. Costs vary widely — the 90th percentile is $13.55 per claim, 8.6× the median.
Total Paid
$148K
0.00% of all spending
Total Claims
85K
Providers
90
Avg Cost/Claim
$2
National Cost Distribution
How much do providers bill per claim for J7070? Based on 65 providers billing this code nationally.
Median
$1.57
Average
$7.10
Std Dev
$18.84
Max
$131.80
Percentile Distribution (Cost per Claim)
50% of providers bill between $0.37 and $5.04 per claim for this code.
90% bill between $0.17 and $13.55.
Top 1% bill above $83.31.
About This Procedure
HCPCS code J7070 was billed by 90 providers across 85K claims, totaling $148K in Medicaid payments from 2018–2024. This code was used for 45K 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
$1.57
Providers Billing
65
National Spending
$148K
Avg/Median Ratio
4.52×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for J7070
| # | Provider | Total Paid |
|---|---|---|
| 1 | Beth Israel Deaconess Medical Center, Inc. Boston, MA · General Acute Care Hospital | $28K |
| 2 | Pikeville Medical Center Inc Pikeville, KY · General Acute Care Hospital | $25K |
| 3 | Adventist Health System-sunbelt, Inc Orlando, FL · Ambulance, Land Transport | $21K |
| 4 | 1235196510 | $12K |
| 5 | Vhs Childrens Hospital Of Michigan Inc Detroit, MI · Clinic/Center, Ambulatory Surgical | $9K |
| 6 | 1417901091 | $8K |
| 7 | 1477596583 | $4K |
| 8 | San Juan Regional Medical Center, Inc. Farmington, NM · Audiologist | $4K |
| 9 | 1053720243 | $4K |
| 10 | 1962442012 | $4K |
| 11 | 1740208081 | $4K |
| 12 | Scottish Rite Children's Medical Center Atlanta, GA · Pediatrics Pediatric Hematology-Oncology | $4K |
| 13 | University Of Kentucky Lexington, KY · General Acute Care Hospital | $3K |
| 14 | Children's Hospital Of Wisconsin, Inc. Milwaukee, WI · Dentist, Pediatric Dentistry | $2K |
| 15 | University Of California Irvine Orange, CA · General Acute Care Hospital | $2K |
| 16 | 1992701429 | $1K |
| 17 | 1932197258 | $1K |
| 18 | 1356307581 | $1K |
| 19 | 1649344987 | $1K |
| 20 | 1679660617 | $1K |
Showing top 20 of 90 providers billing this code