J7318
HCPCS Procedure Code
HCPCS code J7318 is the #3,448 most-billed Medicaid procedure code, with $1.7M in payments across 2K claims from 2018–2024. The national median cost per claim is $505.91. Costs vary widely — the 90th percentile is $1,108.06 per claim, 2.2× the median.
Total Paid
$1.7M
0.00% of all spending
Total Claims
2K
Providers
21
Avg Cost/Claim
$720
National Cost Distribution
How much do providers bill per claim for J7318? Based on 18 providers billing this code nationally.
Median
$505.91
Average
$558.03
Std Dev
$390.31
Max
$1,218.72
Percentile Distribution (Cost per Claim)
50% of providers bill between $245.68 and $886.52 per claim for this code.
90% bill between $162.13 and $1,108.06.
Top 1% bill above $1,214.47.
About This Procedure
HCPCS code J7318 was billed by 21 providers across 2K claims, totaling $1.7M in Medicaid payments from 2018–2024. This code was used for 2K 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
$505.91
Providers Billing
18
National Spending
$1.7M
Avg/Median Ratio
1.10×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for J7318
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1083045140 | $785K |
| 2 | Accredo Health Group Inc Memphis, TN · Pharmacy | $277K |
| 3 | The Cleveland Clinic Foundation Cleveland, OH · General Acute Care Hospital | $154K |
| 4 | 1427095801 | $128K |
| 5 | 1902092281 | $93K |
| 6 | Riverside University Health Systems - Medical Center Moreno Valley, CA · General Acute Care Hospital | $51K |
| 7 | 1770805590 | $37K |
| 8 | 1134100134 | $36K |
| 9 | 1306818331 | $35K |
| 10 | 1164495503 | $32K |
| 11 | 1871547315 | $27K |
| 12 | Maricopa County Special Health Care District Phoenix, AZ · General Acute Care Hospital | $9K |
| 13 | Ochsner Clinic Foundation New Orleans, LA · General Acute Care Hospital | $5K |
| 14 | 1285253252 | $4K |
| 15 | 1013981554 | $3K |
| 16 | 1144480518 | $3K |
| 17 | Presbyterian Healthcare Services Albuquerque, NM · Surgery | $1K |
| 18 | 1972941474 | $291 |
| 19 | 1972500304 | $0 |
| 20 | Geisinger Clinic Danville, PA · Surgery | $0 |
Showing top 20 of 21 providers billing this code