#4116 of 11K

J7328

HCPCS Procedure Code

HCPCS code J7328 is the #4,116 most-billed Medicaid procedure code, with $834K in payments across 25K claims from 2018–2024. The national median cost per claim is $110.79. Costs vary widely — the 90th percentile is $374.19 per claim, 3.4× the median.

Total Paid

$834K

0.00% of all spending

Total Claims

25K

Providers

Avg Cost/Claim

$34

National Cost Distribution

How much do providers bill per claim for J7328? Based on 30 providers billing this code nationally.

Median

$110.79

Average

$175.31

Std Dev

$253.57

Max

$1,306.44

Percentile Distribution (Cost per Claim)

p10

$6.69

p25

$37.80

Median

$110.79

p75

$209.73

p90

$374.19

p95

$500.48

p99

$1,074.98

50% of providers bill between $37.80 and $209.73 per claim for this code.

90% bill between $6.69 and $374.19.

Top 1% bill above $1,074.98.

About This Procedure

HCPCS code J7328 was billed by 41 providers across 25K claims, totaling $834K in Medicaid payments from 2018–2024. This code was used for 10K 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

$110.79

Providers Billing

National Spending

$834K

Avg/Median Ratio

1.58×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for J7328

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1508817248	$166K	$167.00	1.5× median	Above Median
2	1962438564	$111K	$219.06	2.0× median	Above 75th
3	1083045140	$105K	$1,306.44	11.8× median	Top 1%
4	1285798033	$78K	$177.18	1.6× median	Above Median
5	1548418627	$66K	$285.79	2.6× median	Above 75th
6	1770756215	$58K	$361.22	3.3× median	Above 75th
7	1568808772	$39K	$57.76	0.5× median	Below Median
8	1902092281	$37K	$210.12	1.9× median	Above 75th
9	1275736829	$29K	$490.92	4.4× median	Top 10%
10	1427016385	$25K	$127.03	1.1× median	Above Median
11	1346761897	$24K	$37.32	0.3× median	Below Median
12	1861418220	$19K	$39.21	0.4× median	Below Median
13	1720094337	$16K	$199.11	1.8× median	Above Median
14	1508131087	$14K	$508.30	4.6× median	Top 10%
15	1548538200	$7K	$208.59	1.9× median	Above Median
16	1306841002	$5K	$123.60	1.1× median	Above Median
17	University Of Cincinnati Medical Center, Llc Cincinnati, OH · General Acute Care Hospital	$5K	$24.07	0.2× median	Below Median
18	1467401315	$4K	$242.28	2.2× median	Above 75th
19	1154464329	$4K	$14.68	0.1× median	Below Median
20	1366826299	$4K	$9.52	0.1× median	Below Median

Showing top 20 of 41 providers billing this code

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