J8499
HCPCS Procedure Code
HCPCS code J8499 is the #1,405 most-billed Medicaid procedure code, with $24.1M in payments across 4.0M claims from 2018–2024. The national median cost per claim is $1.99. Costs vary widely — the 90th percentile is $25.55 per claim, 12.8× the median.
Total Paid
$24.1M
0.00% of all spending
Total Claims
4.0M
Providers
777
Avg Cost/Claim
$6
National Cost Distribution
How much do providers bill per claim for J8499? Based on 593 providers billing this code nationally.
Median
$1.99
Average
$8.73
Std Dev
$20.65
Max
$351.23
Percentile Distribution (Cost per Claim)
50% of providers bill between $0.24 and $8.80 per claim for this code.
90% bill between $0.01 and $25.55.
Top 1% bill above $66.03.
About This Procedure
HCPCS code J8499 was billed by 777 providers across 4.0M claims, totaling $24.1M in Medicaid payments from 2018–2024. This code was used for 1.8M 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
$1.99
Providers Billing
593
National Spending
$24.1M
Avg/Median Ratio
4.39×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for J8499
| # | Provider | Total Paid |
|---|---|---|
| 1 | University Of Utah Salt Lake City, UT · Clinic/Center, Dental | $6.2M |
| 2 | 1457382483 | $2.8M |
| 3 | The Nemours Foundation Orlando, FL · General Acute Care Hospital Children | $1.7M |
| 4 | 1629057146 | $1.5M |
| 5 | Carolinas Medical Center Charlotte, NC · General Acute Care Hospital | $1.3M |
| 6 | 1417432840 | $773K |
| 7 | 1396790325 | $696K |
| 8 | Childrens Hospital Of Philadelphia Philadelphia, PA · General Acute Care Hospital Children | $595K |
| 9 | Providence Health & Services Washington Anchorage, AK · General Acute Care Hospital | $572K |
| 10 | Southeast Alaska Regional Health Consortium Sitka, AK · Podiatrist | $397K |
| 11 | 1568461572 | $395K |
| 12 | 1780859280 | $342K |
| 13 | 1962472431 | $341K |
| 14 | 1093989667 | $329K |
| 15 | 1447700596 | $262K |
| 16 | 1831363464 | $211K |
| 17 | Childrens Hospital Of The Kings Daughters Inc Norfolk, VA · Social Worker, Clinical | $206K |
| 18 | 1386885671 | $182K |
| 19 | 1851344907 | $181K |
| 20 | Children's Hospital & Research Center At Oakland Oakland, CA · General Acute Care Hospital | $164K |
Showing top 20 of 777 providers billing this code