J9305
Injection, pemetrexed, ten milligrams
Injection, pemetrexed, ten milligrams is the #2,020 most-billed Medicaid procedure code, with $10.0M in payments across 9K claims from 2018–2024. The national median cost per claim is $1,245.54.
Total Paid
$10.0M
0.00% of all spending
Total Claims
9K
Providers
27
Avg Cost/Claim
$1K
National Cost Distribution
How much do providers bill per claim for J9305? Based on 24 providers billing this code nationally.
Median
$1,245.54
Average
$1,422.70
Std Dev
$1,573.55
Max
$7,284.80
Percentile Distribution (Cost per Claim)
50% of providers bill between $388.39 and $1,817.45 per claim for this code.
90% bill between $150.00 and $2,350.28.
Top 1% bill above $6,536.84.
About This Procedure
HCPCS code J9305 (Injection, pemetrexed, ten milligrams) was billed by 27 providers across 9K claims, totaling $10.0M in Medicaid payments from 2018–2024. This code was used for 4K 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
$1,245.54
Providers Billing
24
National Spending
$10.0M
Avg/Median Ratio
1.14×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for J9305
| # | Provider | Total Paid |
|---|---|---|
| 1 | Yale New Haven Hospital New Haven, CT · General Acute Care Hospital | $2.9M |
| 2 | The Cooper Health System Camden, NJ · General Acute Care Hospital | $1.9M |
| 3 | Dana-farber Cancer Institute, Inc. Boston, MA · General Acute Care Hospital | $1.2M |
| 4 | Stanford Health Care Stanford, CA · General Acute Care Hospital | $562K |
| 5 | Memorial Hospital For Cancer And Allied Diseases New York, NY · Pharmacy | $516K |
| 6 | The General Hospital Corporation Boston, MA · General Acute Care Hospital | $357K |
| 7 | 1528018389 | $302K |
| 8 | Long Island Jewish Medical Center New Hyde Park, NY · General Acute Care Hospital | $290K |
| 9 | 1275157455 | $257K |
| 10 | Alivia Specialty Llc Guaynabo, PR · Pharmacy Specialty Pharmacy | $250K |
| 11 | City Of Hope National Medical Center Duarte, CA · General Acute Care Hospital | $243K |
| 12 | Eastern Maine Medical Center Bangor, ME · General Acute Care Hospital | $203K |
| 13 | Upmc Magee-womens Hospital Pittsburgh, PA · General Acute Care Hospital | $191K |
| 14 | University Of California Irvine Orange, CA · General Acute Care Hospital | $163K |
| 15 | University Of Kentucky Lexington, KY · General Acute Care Hospital | $129K |
| 16 | University Hospitals Cleveland Medical Center Cleveland, OH · General Acute Care Hospital | $94K |
| 17 | 1548315401 | $87K |
| 18 | 1164493847 | $78K |
| 19 | Aurora Health Care Metro, Inc. Milwaukee, WI · Internal Medicine, Hematology & Oncology | $65K |
| 20 | 1295023547 | $32K |
Showing top 20 of 27 providers billing this code