J9190
HCPCS Procedure Code
HCPCS code J9190 is the #2,966 most-billed Medicaid procedure code, with $2.9M in payments across 302K claims from 2018–2024. The national median cost per claim is $9.86. Costs vary widely — the 90th percentile is $30.00 per claim, 3.0× the median.
Total Paid
$2.9M
0.00% of all spending
Total Claims
302K
Providers
283
Avg Cost/Claim
$10
National Cost Distribution
How much do providers bill per claim for J9190? Based on 236 providers billing this code nationally.
Median
$9.86
Average
$14.83
Std Dev
$28.89
Max
$384.05
Percentile Distribution (Cost per Claim)
50% of providers bill between $3.00 and $17.56 per claim for this code.
90% bill between $0.33 and $30.00.
Top 1% bill above $94.28.
About This Procedure
HCPCS code J9190 was billed by 283 providers across 302K claims, totaling $2.9M in Medicaid payments from 2018–2024. This code was used for 122K 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
$9.86
Providers Billing
236
National Spending
$2.9M
Avg/Median Ratio
1.50×
Moderately skewed
Top Providers Billing This Code
Ranked by total Medicaid payments for J9190
| # | Provider | Total Paid |
|---|---|---|
| 1 | Rhode Island Hospital Providence, RI · General Acute Care Hospital | $442K |
| 2 | 1003989831 | $162K |
| 3 | 1538147202 | $108K |
| 4 | Alivia Specialty Llc Guaynabo, PR · Pharmacy Specialty Pharmacy | $102K |
| 5 | Arthur G James Cancer Hospital And Research Institute Columbus, OH · Special Hospital | $100K |
| 6 | The Cooper Health System Camden, NJ · General Acute Care Hospital | $88K |
| 7 | Long Island Jewish Medical Center New Hyde Park, NY · General Acute Care Hospital | $83K |
| 8 | City Of Hope National Medical Center Duarte, CA · General Acute Care Hospital | $82K |
| 9 | Keck Medical Center Of Usc Los Angeles, CA · General Acute Care Hospital | $69K |
| 10 | 1528018389 | $65K |
| 11 | Stanford Health Care Stanford, CA · General Acute Care Hospital | $62K |
| 12 | 1679660617 | $56K |
| 13 | Unm Hospital Albuquerque, NM · General Acute Care Hospital | $55K |
| 14 | 1184709909 | $51K |
| 15 | Memorial Hospital For Cancer And Allied Diseases New York, NY · Pharmacy | $47K |
| 16 | University Medical Center, Inc Louisville, KY · Student in an Organized Health Care Education/Training Program | $45K |
| 17 | 1396087672 | $45K |
| 18 | Dana-farber Cancer Institute, Inc. Boston, MA · General Acute Care Hospital | $40K |
| 19 | Regents Of The University Of California San Diego, CA · General Acute Care Hospital | $39K |
| 20 | 1497756373 | $37K |
Showing top 20 of 283 providers billing this code