#1506 of 11K

J7300

HCPCS Procedure Code

HCPCS code J7300 is the #1,506 most-billed Medicaid procedure code, with $20.8M in payments across 33K claims from 2018–2024. The national median cost per claim is $692.75.

Total Paid

$20.8M

0.00% of all spending

Total Claims

33K

Providers

127

Avg Cost/Claim

$632

National Cost Distribution

How much do providers bill per claim for J7300? Based on 125 providers billing this code nationally.

Median

$692.75

Average

$690.28

Std Dev

$321.31

Max

$2,549.22

Percentile Distribution (Cost per Claim)

p10

$247.95

p25

$560.06

Median

$692.75

p75

$867.81

p90

$1,028.45

p95

$1,086.93

p99

$1,215.31

50% of providers bill between $560.06 and $867.81 per claim for this code.

90% bill between $247.95 and $1,028.45.

Top 1% bill above $1,215.31.

About This Procedure

HCPCS code J7300 was billed by 127 providers across 33K claims, totaling $20.8M in Medicaid payments from 2018–2024. This code was used for 32K 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

$692.75

Providers Billing

125

National Spending

$20.8M

Avg/Median Ratio

1.00×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for J7300

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	Planned Parenthood/orange And San Bernardino Counties, Inc. Orange, CA · Clinic/Center, Ambulatory Family Planning Facility	$5.1M	$703.69	1.0× median	Above Median
2	1417959701	$2.0M	$430.18	0.6× median	Below Median
3	Henry Ford Health System Detroit, MI · General Acute Care Hospital	$1.7M	$941.24	1.4× median	Above 75th
4	1487640314	$866K	$731.76	1.1× median	Above Median
5	1285701672	$809K	$652.02	0.9× median	Below Median
6	1629057146	$714K	$1,025.51	1.5× median	Above 75th
7	New York City Health And Hospitals Corporation Bronx, NY · Internal Medicine	$669K	$1,010.12	1.5× median	Above 75th
8	1366525370	$657K	$320.04	0.5× median	Below Median
9	1821095779	$604K	$466.21	0.7× median	Below Median
10	1063486959	$488K	$1,032.64	1.5× median	Top 10%
11	1336174325	$480K	$847.80	1.2× median	Above Median
12	1730136680	$445K	$394.23	0.6× median	Below Median
13	1538444005	$438K	$811.83	1.2× median	Above Median
14	1972880623	$325K	$912.99	1.3× median	Above 75th
15	1982116877	$306K	$731.33	1.1× median	Above Median
16	The Cleveland Clinic Foundation Cleveland, OH · General Acute Care Hospital	$301K	$1,030.42	1.5× median	Top 10%
17	1538458153	$286K	$873.67	1.3× median	Above 75th
18	1487749495	$262K	$812.65	1.2× median	Above Median
19	The New York And Presbyterian Hospital New York, NY · General Acute Care Hospital	$241K	$456.35	0.7× median	Below Median
20	1043263189	$234K	$658.64	1.0× median	Below Median

Showing top 20 of 127 providers billing this code

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