Statistical flags indicate unusual patterns — not proof of fraud or wrongdoing. Read our methodology

#483 of 11K

J7307

Etonogestrel implant system, including implant and supplies

Etonogestrel implant system, including implant and supplies is the #483 most-billed Medicaid procedure code, with $192.3M in payments across 264K claims from 2018–2024. The national median cost per claim is $786.43.

Total Paid

$192.3M

0.02% of all spending

Total Claims

264K

Providers

694

Avg Cost/Claim

$729

National Cost Distribution

How much do providers bill per claim for J7307? Based on 657 providers billing this code nationally.

Median

$786.43

Average

$714.07

Std Dev

$330.29

Max

$3,256.47

Percentile Distribution (Cost per Claim)

p10
$292.73
p25
$453.55
Median
$786.43
p75
$910.39
p90
$1,065.53
p95
$1,150.36
p99
$1,458.83

50% of providers bill between $453.55 and $910.39 per claim for this code.

90% bill between $292.73 and $1,065.53.

Top 1% bill above $1,458.83.

About This Procedure

HCPCS code J7307 (Etonogestrel implant system, including implant and supplies) was billed by 694 providers across 264K claims, totaling $192.3M in Medicaid payments from 2018–2024. This code was used for 250K 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

$786.43

Providers Billing

657

National Spending

$192.3M

Avg/Median Ratio

0.91×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for J7307

#ProviderTotal Paid
1Planned Parenthood/orange And San Bernardino Counties, Inc.

Orange, CA · Clinic/Center, Ambulatory Family Planning Facility

$22.7M
2Procare Pharmacy Direct, Llc.

Monroeville, PA · Pharmacy, Community/Retail Pharmacy

$8.3M
31417959701$4.4M
41629057146$4.1M
51336174325$3.3M
61487749495$3.2M
71518039858$2.9M
81982798831$2.6M
91497847487$2.4M
10Boston Medical Center Corporation

Boston, MA · General Acute Care Hospital

$2.4M
111366525370$2.4M
121114264660$2.2M
131821095779$2.1M
141417938820$1.9M
15Spectrum Health Primary Care Partners

Grand Rapids, MI · Psychologist, Clinical Child & Adolescent

$1.8M
161962456558$1.8M
171366496838$1.8M
181013998921$1.7M
19The Health And Hospital Corporation Of Marion County

Indianapolis, IN · Psychiatric Unit

$1.7M
20Medical Associates Of Ebnhc

East Boston, MA · Clinic/Center, Community Health

$1.7M

Showing top 20 of 694 providers billing this code