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

#3494 of 11K

J7326

HCPCS Procedure Code

HCPCS code J7326 is the #3,494 most-billed Medicaid procedure code, with $1.6M in payments across 1K claims from 2018–2024. The national median cost per claim is $997.91.

Total Paid

$1.6M

0.00% of all spending

Total Claims

1K

Providers

9

Avg Cost/Claim

$1K

National Cost Distribution

How much do providers bill per claim for J7326? Based on 6 providers billing this code nationally.

Median

$997.91

Average

$911.68

Std Dev

$474.08

Max

$1,325.80

Percentile Distribution (Cost per Claim)

p10
$427.98
p25
$827.20
Median
$997.91
p75
$1,249.69
p90
$1,309.16
p95
$1,317.48
p99
$1,324.14

50% of providers bill between $827.20 and $1,249.69 per claim for this code.

90% bill between $427.98 and $1,309.16.

Top 1% bill above $1,324.14.

About This Procedure

HCPCS code J7326 was billed by 9 providers across 1K claims, totaling $1.6M in Medicaid payments from 2018–2024. This code was used for 1K 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

$997.91

Providers Billing

6

National Spending

$1.6M

Avg/Median Ratio

0.91×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for J7326

#ProviderTotal Paid
11932400397$813K
2Presbyterian Healthcare Services

Albuquerque, NM · Surgery

$631K
31477567394$85K
41831418078$45K
51134100134$31K
61407805500$3K
71720395205$0
81396725081$0
91235292574$0

Showing top 9 of 9 providers billing this code