J9201
HCPCS Procedure Code
HCPCS code J9201 is the #3,534 most-billed Medicaid procedure code, with $1.5M in payments across 42K claims from 2018–2024. The national median cost per claim is $24.45. Costs vary widely — the 90th percentile is $127.44 per claim, 5.2× the median.
Total Paid
$1.5M
0.00% of all spending
Total Claims
42K
Providers
66
Avg Cost/Claim
$37
National Cost Distribution
How much do providers bill per claim for J9201? Based on 49 providers billing this code nationally.
Median
$24.45
Average
$53.48
Std Dev
$84.82
Max
$468.49
Percentile Distribution (Cost per Claim)
50% of providers bill between $14.82 and $45.62 per claim for this code.
90% bill between $7.87 and $127.44.
Top 1% bill above $402.68.
About This Procedure
HCPCS code J9201 was billed by 66 providers across 42K claims, totaling $1.5M in Medicaid payments from 2018–2024. This code was used for 17K 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
$24.45
Providers Billing
49
National Spending
$1.5M
Avg/Median Ratio
2.19×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for J9201
| # | Provider | Total Paid |
|---|---|---|
| 1 | Dana-farber Cancer Institute, Inc. Boston, MA · General Acute Care Hospital | $481K |
| 2 | The General Hospital Corporation Boston, MA · General Acute Care Hospital | $143K |
| 3 | Memorial Hospital For Cancer And Allied Diseases New York, NY · Pharmacy | $135K |
| 4 | 1164493847 | $114K |
| 5 | Keck Medical Center Of Usc Los Angeles, CA · General Acute Care Hospital | $55K |
| 6 | The Cooper Health System Camden, NJ · General Acute Care Hospital | $53K |
| 7 | Arthur G James Cancer Hospital And Research Institute Columbus, OH · Special Hospital | $47K |
| 8 | Stanford Health Care Stanford, CA · General Acute Care Hospital | $46K |
| 9 | Alivia Specialty Llc Guaynabo, PR · Pharmacy Specialty Pharmacy | $44K |
| 10 | Seventh-day Adventists Loma Linda University Medical Center Loma Linda, CA · General Acute Care Hospital | $41K |
| 11 | City Of Hope National Medical Center Duarte, CA · General Acute Care Hospital | $38K |
| 12 | Banner - University Medical Center Tucson Campus Llc Tucson, AZ · Clinic/Center, Multi-Specialty | $34K |
| 13 | 1679660617 | $31K |
| 14 | 1528018389 | $29K |
| 15 | The New York And Presbyterian Hospital New York, NY · General Acute Care Hospital | $24K |
| 16 | Regents Of The University Of California San Diego, CA · General Acute Care Hospital | $24K |
| 17 | University Of California Irvine Orange, CA · General Acute Care Hospital | $23K |
| 18 | 1770728438 | $21K |
| 19 | Multicare Health System Tacoma, WA · Community/Behavioral Health | $21K |
| 20 | Montefiore Medical Center Bronx, NY · General Acute Care Hospital | $16K |
Showing top 20 of 66 providers billing this code