J9196
HCPCS Procedure Code
HCPCS code J9196 is the #8,880 most-billed Medicaid procedure code, with $889 in payments across 45 claims from 2018–2024. The national median cost per claim is $21.43.
Total Paid
$889
0.00% of all spending
Total Claims
45
Providers
2
Avg Cost/Claim
$20
National Cost Distribution
How much do providers bill per claim for J9196? Based on 2 providers billing this code nationally.
Median
$21.43
Average
$21.43
Std Dev
$21.30
Max
$36.49
Percentile Distribution (Cost per Claim)
50% of providers bill between $13.90 and $28.96 per claim for this code.
90% bill between $9.38 and $33.47.
Top 1% bill above $36.18.
About This Procedure
HCPCS code J9196 was billed by 2 providers across 45 claims, totaling $889 in Medicaid payments from 2018–2024. This code was used for 24 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
$21.43
Providers Billing
2
National Spending
$889
Avg/Median Ratio
1.00×
Normal distribution
Provider Coverage
We have 2 providers billing this code in our dataset. Individual provider breakdowns are available for top-spending procedure codes.