#2243 of 11K

J7518

HCPCS Procedure Code

HCPCS code J7518 is the #2,243 most-billed Medicaid procedure code, with $7.5M in payments across 244K claims from 2018–2024. The national median cost per claim is $34.13. Costs vary widely — the 90th percentile is $70.43 per claim, 2.1× the median.

Total Paid

$7.5M

0.00% of all spending

Total Claims

244K

Providers

144

Avg Cost/Claim

$31

National Cost Distribution

How much do providers bill per claim for J7518? Based on 132 providers billing this code nationally.

Median

$34.13

Average

$40.11

Std Dev

$46.60

Max

$455.42

Percentile Distribution (Cost per Claim)

p10

$3.86

p25

$13.78

Median

$34.13

p75

$52.24

p90

$70.43

p95

$92.05

p99

$148.56

50% of providers bill between $13.78 and $52.24 per claim for this code.

90% bill between $3.86 and $70.43.

Top 1% bill above $148.56.

About This Procedure

HCPCS code J7518 was billed by 144 providers across 244K claims, totaling $7.5M in Medicaid payments from 2018–2024. This code was used for 210K 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

$34.13

Providers Billing

132

National Spending

$7.5M

Avg/Median Ratio

1.18×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for J7518

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1417901646	$398K	$31.24	0.9× median	Below Median
2	1770586349	$364K	$54.95	1.6× median	Above 75th
3	1255634218	$256K	$26.84	0.8× median	Below Median
4	1083038368	$251K	$47.03	1.4× median	Above Median
5	1932135068	$241K	$63.81	1.9× median	Above 75th
6	1619946746	$240K	$29.82	0.9× median	Below Median
7	1871929224	$229K	$58.22	1.7× median	Above 75th
8	1437513876	$229K	$39.98	1.2× median	Above Median
9	1790856458	$227K	$17.81	0.5× median	Below Median
10	1801819818	$216K	$46.30	1.4× median	Above Median
11	1619080942	$190K	$47.73	1.4× median	Above Median
12	1790147833	$179K	$35.92	1.1× median	Above Median
13	1396128864	$175K	$54.05	1.6× median	Above 75th
14	1881027290	$173K	$45.77	1.3× median	Above Median
15	1760827414	$158K	$86.52	2.5× median	Top 10%
16	1730452129	$156K	$39.65	1.2× median	Above Median
17	1881601896	$151K	$98.82	2.9× median	Top 10%
18	1346242542	$147K	$37.73	1.1× median	Above Median
19	1144550039	$138K	$72.75	2.1× median	Top 10%
20	1982710554	$135K	$50.42	1.5× median	Above Median

Showing top 20 of 144 providers billing this code

Related Procedures

J7517$2.9M J7512$2.8M J7527$632K J7510Prednisolone oral, per five milligrams$380K J7520$243K

← All procedures Top providers →