#2961 of 11K

J7517

HCPCS Procedure Code

HCPCS code J7517 is the #2,961 most-billed Medicaid procedure code, with $2.9M in payments across 279K claims from 2018–2024. The national median cost per claim is $7.59. Costs vary widely — the 90th percentile is $23.78 per claim, 3.1× the median.

Total Paid

$2.9M

0.00% of all spending

Total Claims

279K

Providers

174

Avg Cost/Claim

$10

National Cost Distribution

How much do providers bill per claim for J7517? Based on 159 providers billing this code nationally.

Median

$7.59

Average

$11.34

Std Dev

$11.36

Max

$67.45

Percentile Distribution (Cost per Claim)

p10

$1.33

p25

$2.88

Median

$7.59

p75

$17.71

p90

$23.78

p95

$29.50

p99

$51.86

50% of providers bill between $2.88 and $17.71 per claim for this code.

90% bill between $1.33 and $23.78.

Top 1% bill above $51.86.

About This Procedure

HCPCS code J7517 was billed by 174 providers across 279K claims, totaling $2.9M in Medicaid payments from 2018–2024. This code was used for 242K 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

$7.59

Providers Billing

159

National Spending

$2.9M

Avg/Median Ratio

1.49×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for J7517

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1396128864	$166K	$20.65	2.7× median	Above 75th
2	1437253168	$163K	$15.86	2.1× median	Above Median
3	1932135068	$154K	$20.61	2.7× median	Above 75th
4	1013913458	$130K	$17.14	2.3× median	Above Median
5	1225482490	$119K	$19.21	2.5× median	Above 75th
6	1679676639	$93K	$25.52	3.4× median	Top 10%
7	1013925122	$93K	$22.11	2.9× median	Above 75th
8	1285091330	$88K	$17.95	2.4× median	Above 75th
9	1265538664	$85K	$18.11	2.4× median	Above 75th
10	1831594092	$72K	$12.53	1.7× median	Above Median
11	1770586349	$68K	$15.28	2.0× median	Above Median
12	1801819818	$59K	$12.93	1.7× median	Above Median
13	1053732107	$55K	$13.67	1.8× median	Above Median
14	1760827414	$48K	$21.45	2.8× median	Above 75th
15	1437513876	$47K	$7.16	0.9× median	Below Median
16	1417100447	$47K	$18.74	2.5× median	Above 75th
17	1871959551	$45K	$20.00	2.6× median	Above 75th
18	1578639308	$45K	$6.81	0.9× median	Below Median
19	1699836205	$45K	$4.39	0.6× median	Below Median
20	1588992861	$44K	$26.12	3.4× median	Top 10%

Showing top 20 of 174 providers billing this code

Related Procedures

J7518$7.5M J7507Tacrolimus, immediate release, oral, per milligram$5.4M J7512$2.8M J7527$632K J7510Prednisolone oral, per five milligrams$380K

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