Statistical flags indicate unusual patterns — not proof of fraud or wrongdoing. Read our methodology

#5367 of 11K

J9060

HCPCS Procedure Code

HCPCS code J9060 is the #5,367 most-billed Medicaid procedure code, with $218K in payments across 22K claims from 2018–2024. The national median cost per claim is $13.42. Costs vary widely — the 90th percentile is $33.76 per claim, 2.5× the median.

Total Paid

$218K

0.00% of all spending

Total Claims

22K

Providers

58

Avg Cost/Claim

$10

National Cost Distribution

How much do providers bill per claim for J9060? Based on 41 providers billing this code nationally.

Median

$13.42

Average

$17.82

Std Dev

$18.60

Max

$112.26

Percentile Distribution (Cost per Claim)

p10
$3.22
p25
$8.22
Median
$13.42
p75
$20.61
p90
$33.76
p95
$42.29
p99
$84.49

50% of providers bill between $8.22 and $20.61 per claim for this code.

90% bill between $3.22 and $33.76.

Top 1% bill above $84.49.

About This Procedure

HCPCS code J9060 was billed by 58 providers across 22K claims, totaling $218K in Medicaid payments from 2018–2024. This code was used for 9K 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

$13.42

Providers Billing

41

National Spending

$218K

Avg/Median Ratio

1.33×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for J9060

#ProviderTotal Paid
1Arthur G James Cancer Hospital And Research Institute

Columbus, OH · Special Hospital

$32K
2Alivia Specialty Llc

Guaynabo, PR · Pharmacy Specialty Pharmacy

$27K
3Regents Of The University Of California

San Diego, CA · General Acute Care Hospital

$17K
4Seventh-day Adventists Loma Linda University Medical Center

Loma Linda, CA · General Acute Care Hospital

$16K
5University Of Kentucky

Lexington, KY · General Acute Care Hospital

$16K
6Memorial Hospital For Cancer And Allied Diseases

New York, NY · Pharmacy

$15K
7University Of California Irvine

Orange, CA · General Acute Care Hospital

$15K
8Dana-farber Cancer Institute, Inc.

Boston, MA · General Acute Care Hospital

$10K
9City Of Hope National Medical Center

Duarte, CA · General Acute Care Hospital

$9K
101528018389$8K
111003989831$8K
12Charleston Area Medical Center Inc

Charleston, WV · General Acute Care Hospital

$4K
13University Hospitals Cleveland Medical Center

Cleveland, OH · General Acute Care Hospital

$4K
14Long Island Jewish Medical Center

New Hyde Park, NY · General Acute Care Hospital

$4K
15Montefiore Medical Center

Bronx, NY · General Acute Care Hospital

$4K
16The Cleveland Clinic Foundation

Cleveland, OH · General Acute Care Hospital

$4K
171730209545$3K
181437230034$3K
19Norton Hospitals, Inc

Louisville, KY · General Acute Care Hospital

$3K
20Upmc Magee-womens Hospital

Pittsburgh, PA · General Acute Care Hospital

$2K

Showing top 20 of 58 providers billing this code

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