J9267
HCPCS Procedure Code
HCPCS code J9267 is the #3,161 most-billed Medicaid procedure code, with $2.3M in payments across 168K claims from 2018–2024. The national median cost per claim is $13.72. Costs vary widely — the 90th percentile is $44.62 per claim, 3.3× the median.
Total Paid
$2.3M
0.00% of all spending
Total Claims
168K
Providers
174
Avg Cost/Claim
$14
National Cost Distribution
How much do providers bill per claim for J9267? Based on 134 providers billing this code nationally.
Median
$13.72
Average
$30.40
Std Dev
$104.90
Max
$1,155.97
Percentile Distribution (Cost per Claim)
50% of providers bill between $3.39 and $24.60 per claim for this code.
90% bill between $0.26 and $44.62.
Top 1% bill above $271.23.
About This Procedure
HCPCS code J9267 was billed by 174 providers across 168K claims, totaling $2.3M in Medicaid payments from 2018–2024. This code was used for 70K 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
$13.72
Providers Billing
134
National Spending
$2.3M
Avg/Median Ratio
2.22×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for J9267
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1396087672 | $184K |
| 2 | Englewood Hospital And Medical Center Englewood, NJ · General Acute Care Hospital | $160K |
| 3 | Alivia Specialty Llc Guaynabo, PR · Pharmacy Specialty Pharmacy | $115K |
| 4 | Regents Of The University Of California San Diego, CA · General Acute Care Hospital | $89K |
| 5 | Arthur G James Cancer Hospital And Research Institute Columbus, OH · Special Hospital | $84K |
| 6 | University Of Kentucky Lexington, KY · General Acute Care Hospital | $83K |
| 7 | 1003989831 | $81K |
| 8 | Long Island Jewish Medical Center New Hyde Park, NY · General Acute Care Hospital | $81K |
| 9 | University Of California Irvine Orange, CA · General Acute Care Hospital | $80K |
| 10 | City Of Hope National Medical Center Duarte, CA · General Acute Care Hospital | $78K |
| 11 | Seventh-day Adventists Loma Linda University Medical Center Loma Linda, CA · General Acute Care Hospital | $77K |
| 12 | Hmh Hospitals Corporation Hackensack, NJ · Ambulance | $65K |
| 13 | Memorial Hospital For Cancer And Allied Diseases New York, NY · Pharmacy | $62K |
| 14 | Women & Infants Hospital Of Rhode Island Providence, RI · Clinic/Center, Ambulatory Family Planning Facility | $57K |
| 15 | 1437230034 | $56K |
| 16 | Stanford Health Care Stanford, CA · General Acute Care Hospital | $54K |
| 17 | The Cooper Health System Camden, NJ · General Acute Care Hospital | $53K |
| 18 | Dana-farber Cancer Institute, Inc. Boston, MA · General Acute Care Hospital | $51K |
| 19 | Montefiore Medical Center Bronx, NY · General Acute Care Hospital | $45K |
| 20 | Maimonides Medical Center Brooklyn, NY · General Acute Care Hospital | $41K |
Showing top 20 of 174 providers billing this code