J7189
HCPCS Procedure Code
HCPCS code J7189 is the #1,823 most-billed Medicaid procedure code, with $13.3M in payments across 420 claims from 2018–2024. The national median cost per claim is $31,680.18.
Total Paid
$13.3M
0.00% of all spending
Total Claims
420
Providers
1
Avg Cost/Claim
$32K
National Cost Distribution
How much do providers bill per claim for J7189? Based on 1 providers billing this code nationally.
Median
$31,680.18
Average
$31,680.18
Std Dev
—
Max
$31,680.18
Percentile Distribution (Cost per Claim)
50% of providers bill between $31,680.18 and $31,680.18 per claim for this code.
90% bill between $31,680.18 and $31,680.18.
Top 1% bill above $31,680.18.
About This Procedure
HCPCS code J7189 was billed by 1 providers across 420 claims, totaling $13.3M in Medicaid payments from 2018–2024. This code was used for 309 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
$31,680.18
Providers Billing
1
National Spending
$13.3M
Avg/Median Ratio
1.00×
Normal distribution
Provider Coverage
We have 1 providers billing this code in our dataset. Individual provider breakdowns are available for top-spending procedure codes.