J7606
HCPCS Procedure Code
HCPCS code J7606 is the #2,164 most-billed Medicaid procedure code, with $8.3M in payments across 121K claims from 2018–2024. The national median cost per claim is $76.73. Costs vary widely — the 90th percentile is $164.32 per claim, 2.1× the median.
Total Paid
$8.3M
0.00% of all spending
Total Claims
121K
Providers
18
Avg Cost/Claim
$69
National Cost Distribution
How much do providers bill per claim for J7606? Based on 15 providers billing this code nationally.
Median
$76.73
Average
$94.26
Std Dev
$51.43
Max
$214.86
Percentile Distribution (Cost per Claim)
50% of providers bill between $63.39 and $115.78 per claim for this code.
90% bill between $55.43 and $164.32.
Top 1% bill above $209.01.
About This Procedure
HCPCS code J7606 was billed by 18 providers across 121K claims, totaling $8.3M in Medicaid payments from 2018–2024. This code was used for 99K 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
$76.73
Providers Billing
15
National Spending
$8.3M
Avg/Median Ratio
1.23×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for J7606
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1780748939 | $3.6M |
| 2 | 1003970260 | $1.8M |
| 3 | 1275697435 | $871K |
| 4 | 1134698418 | $716K |
| 5 | 1194725705 | $462K |
| 6 | 1114081270 | $431K |
| 7 | 1114943610 | $192K |
| 8 | 1912060740 | $103K |
| 9 | Super Care Inc City Of Industry, CA · Durable Medical Equipment & Medical Supplies | $102K |
| 10 | 1568465938 | $83K |
| 11 | 1295758688 | $7K |
| 12 | 1669543591 | $6K |
| 13 | 1730177668 | $4K |
| 14 | 1730265331 | $3K |
| 15 | 1407985922 | $2K |
| 16 | Reading Hospital West Reading, PA · Surgery | $0 |
| 17 | 1881906337 | $0 |
| 18 | 1194807339 | $0 |
Showing top 18 of 18 providers billing this code