J7639
HCPCS Procedure Code
HCPCS code J7639 is the #2,484 most-billed Medicaid procedure code, with $5.4M in payments across 6,053 claims from 2018–2024. The national median cost per claim is $415.35. Costs vary widely — the 90th percentile is $1,752.03 per claim, 4.2× the median.
Total Paid
$5.4M
0.00% of all spending
Total Claims
6,053
Providers
7
Avg Cost/Claim
$896
National Cost Distribution
How much do providers bill per claim for J7639? Based on 7 providers billing this code nationally.
Median
$415.35
Average
$785.00
Std Dev
$1,238.35
Max
$3,562.63
Percentile Distribution (Cost per Claim)
50% of providers bill between $189.21 and $530.46 per claim for this code.
90% bill between $104.62 and $1,752.03.
Top 1% bill above $3,381.57.
About This Procedure
HCPCS code J7639 was billed by 7 providers across 6,053 claims, totaling $5.4M in Medicaid payments from 2018–2024. This code was used for 4,722 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
$415.35
Providers Billing
7
National Spending
$5.4M
Avg/Median Ratio
1.89×
Moderately skewed
Top Providers Billing This Code
Ranked by total Medicaid payments for J7639
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1093130031 | $3.9M |
| 2 | 1013913458 | $557K |
| 3 | 1205831963 | $541K |
| 4 | 1508146010 | $218K |
| 5 | 1477571404 | $191K |
| 6 | 1427080415 | $7K |
| 7 | 1942743786 | $3K |
Showing top 7 of 7 providers billing this code