J9155
HCPCS Procedure Code
HCPCS code J9155 is the #6,538 most-billed Medicaid procedure code, with $57K in payments across 647 claims from 2018–2024. The national median cost per claim is $91.11.
Total Paid
$57K
0.00% of all spending
Total Claims
647
Providers
4
Avg Cost/Claim
$89
National Cost Distribution
How much do providers bill per claim for J9155? Based on 4 providers billing this code nationally.
Median
$91.11
Average
$88.75
Std Dev
$24.12
Max
$112.54
Percentile Distribution (Cost per Claim)
50% of providers bill between $73.41 and $106.45 per claim for this code.
90% bill between $65.50 and $110.10.
Top 1% bill above $112.30.
About This Procedure
HCPCS code J9155 was billed by 4 providers across 647 claims, totaling $57K in Medicaid payments from 2018–2024. This code was used for 514 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
$91.11
Providers Billing
4
National Spending
$57K
Avg/Median Ratio
0.97×
Normal distribution
Provider Coverage
We have 4 providers billing this code in our dataset. Individual provider breakdowns are available for top-spending procedure codes.