J9181
HCPCS Procedure Code
HCPCS code J9181 is the #7,463 most-billed Medicaid procedure code, with $17K in payments across 5K claims from 2018–2024. The national median cost per claim is $6.69. Costs vary widely — the 90th percentile is $27.87 per claim, 4.2× the median.
Total Paid
$17K
0.00% of all spending
Total Claims
5K
Providers
11
Avg Cost/Claim
$3
National Cost Distribution
How much do providers bill per claim for J9181? Based on 9 providers billing this code nationally.
Median
$6.69
Average
$12.14
Std Dev
$14.31
Max
$46.26
Percentile Distribution (Cost per Claim)
50% of providers bill between $4.44 and $9.48 per claim for this code.
90% bill between $3.54 and $27.87.
Top 1% bill above $44.42.
About This Procedure
HCPCS code J9181 was billed by 11 providers across 5K claims, totaling $17K in Medicaid payments from 2018–2024. This code was used for 1K 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
$6.69
Providers Billing
9
National Spending
$17K
Avg/Median Ratio
1.81×
Moderately skewed
Top Providers Billing This Code
Ranked by total Medicaid payments for J9181
| # | Provider | Total Paid |
|---|---|---|
| 1 | Dana-farber Cancer Institute, Inc. Boston, MA · General Acute Care Hospital | $5K |
| 2 | Memorial Hospital For Cancer And Allied Diseases New York, NY · Pharmacy | $4K |
| 3 | Alivia Specialty Llc Guaynabo, PR · Pharmacy Specialty Pharmacy | $3K |
| 4 | 1528018389 | $2K |
| 5 | Upmc Magee-womens Hospital Pittsburgh, PA · General Acute Care Hospital | $2K |
| 6 | Arthur G James Cancer Hospital And Research Institute Columbus, OH · Special Hospital | $814 |
| 7 | The Cleveland Clinic Foundation Cleveland, OH · General Acute Care Hospital | $417 |
| 8 | Yale New Haven Hospital New Haven, CT · General Acute Care Hospital | $269 |
| 9 | University Of Kentucky Lexington, KY · General Acute Care Hospital | $254 |
| 10 | Aurora Health Care Metro, Inc. Milwaukee, WI · Internal Medicine, Hematology & Oncology | $0 |
| 11 | Multicare Health System Tacoma, WA · Community/Behavioral Health | $0 |
Showing top 11 of 11 providers billing this code