J7643
HCPCS Procedure Code
HCPCS code J7643 is the #8,762 most-billed Medicaid procedure code, with $1K in payments across 1,552 claims from 2018–2024. The national median cost per claim is $0.40. Costs vary widely — the 90th percentile is $10.63 per claim, 26.6× the median.
Total Paid
$1K
0.00% of all spending
Total Claims
1,552
Providers
16
Avg Cost/Claim
$1
National Cost Distribution
How much do providers bill per claim for J7643? Based on 9 providers billing this code nationally.
Median
$0.40
Average
$4.18
Std Dev
$9.54
Max
$29.12
Percentile Distribution (Cost per Claim)
50% of providers bill between $0.14 and $0.95 per claim for this code.
90% bill between $0.07 and $10.63.
Top 1% bill above $27.27.
About This Procedure
HCPCS code J7643 was billed by 16 providers across 1,552 claims, totaling $1K in Medicaid payments from 2018–2024. This code was used for 1,240 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
$0.40
Providers Billing
9
National Spending
$1K
Avg/Median Ratio
10.45×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for J7643
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1417975061 | $641 |
| 2 | 1992703540 | $270 |
| 3 | 1710491253 | $110 |
| 4 | 1659757268 | $107 |
| 5 | Virtua - West Jersey Health System Inc. Voorhees, NJ · General Acute Care Hospital | $58 |
| 6 | 1023301561 | $45 |
| 7 | 1235134024 | $29 |
| 8 | 1134125016 | $8 |
| 9 | 1053316844 | $5 |
| 10 | 1912900168 | $0 |
| 11 | 1942749387 | $0 |
| 12 | 1083609150 | $0 |
| 13 | 1639172372 | $0 |
| 14 | 1386755460 | $0 |
| 15 | Alaska Native Tribal Health Consortium Anchorage, AK · General Acute Care Hospital | $0 |
| 16 | 1982780094 | $0 |
Showing top 16 of 16 providers billing this code