J7527
HCPCS Procedure Code
HCPCS code J7527 is the #4,370 most-billed Medicaid procedure code, with $632K in payments across 2K claims from 2018–2024. The national median cost per claim is $174.56. Costs vary widely — the 90th percentile is $658.31 per claim, 3.8× the median.
Total Paid
$632K
0.00% of all spending
Total Claims
2K
Providers
6
Avg Cost/Claim
$319
National Cost Distribution
How much do providers bill per claim for J7527? Based on 5 providers billing this code nationally.
Median
$174.56
Average
$327.29
Std Dev
$303.65
Max
$677.32
Percentile Distribution (Cost per Claim)
50% of providers bill between $134.77 and $629.79 per claim for this code.
90% bill between $65.93 and $658.31.
Top 1% bill above $675.41.
About This Procedure
HCPCS code J7527 was billed by 6 providers across 2K claims, totaling $632K in Medicaid payments from 2018–2024. This code was used for 2K 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
$174.56
Providers Billing
5
National Spending
$632K
Avg/Median Ratio
1.87×
Moderately skewed
Top Providers Billing This Code
Ranked by total Medicaid payments for J7527
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1881601896 | $287K |
| 2 | 1790147833 | $207K |
| 3 | 1134582398 | $127K |
| 4 | 1770586349 | $9K |
| 5 | 1790856458 | $2K |
| 6 | 1215356837 | $0 |
Showing top 6 of 6 providers billing this code