#2979 of 11K

J7324

HCPCS Procedure Code

HCPCS code J7324 is the #2,979 most-billed Medicaid procedure code, with $2.9M in payments across 28K claims from 2018–2024. The national median cost per claim is $56.65. Costs vary widely — the 90th percentile is $145.61 per claim, 2.6× the median.

Total Paid

$2.9M

0.00% of all spending

Total Claims

28K

Providers

Avg Cost/Claim

$101

National Cost Distribution

How much do providers bill per claim for J7324? Based on 78 providers billing this code nationally.

Median

$56.65

Average

$156.50

Std Dev

$432.19

Max

$2,727.78

Percentile Distribution (Cost per Claim)

p10

$19.64

p25

$29.85

Median

$56.65

p75

$110.92

p90

$145.61

p95

$445.79

p99

$2,625.23

50% of providers bill between $29.85 and $110.92 per claim for this code.

90% bill between $19.64 and $145.61.

Top 1% bill above $2,625.23.

About This Procedure

HCPCS code J7324 was billed by 82 providers across 28K claims, totaling $2.9M in Medicaid payments from 2018–2024. This code was used for 13K 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

$56.65

Providers Billing

National Spending

$2.9M

Avg/Median Ratio

2.76×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for J7324

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1255644357	$968K	$1,082.56	19.1× median	Top 10%
2	1295842615	$259K	$2,727.78	48.2× median	Top 1%
3	1356505127	$122K	$122.15	2.2× median	Above 75th
4	1114239332	$117K	$490.68	8.7× median	Top 10%
5	1194722801	$116K	$70.17	1.2× median	Above Median
6	1336187475	$105K	$124.31	2.2× median	Above 75th
7	1710134465	$99K	$88.85	1.6× median	Above Median
8	1073957239	$72K	$25.94	0.5× median	Below Median
9	1639294952	$71K	$129.96	2.3× median	Above 75th
10	1437555299	$62K	$95.59	1.7× median	Above Median
11	1235714825	$54K	$43.25	0.8× median	Below Median
12	1902092281	$45K	$199.50	3.5× median	Top 10%
13	1346761897	$45K	$33.70	0.6× median	Below Median
14	1760965586	$43K	$141.32	2.5× median	Above 75th
15	1235168964	$40K	$45.44	0.8× median	Below Median
16	1063690592	$37K	$39.60	0.7× median	Below Median
17	1437146743	$35K	$21.46	0.4× median	Below Median
18	1245340231	$34K	$22.66	0.4× median	Below Median
19	1942836424	$31K	$2,594.59	45.8× median	Top 10%
20	1407252828	$29K	$93.35	1.6× median	Above Median

Showing top 20 of 82 providers billing this code

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