J9312
HCPCS Procedure Code
HCPCS code J9312 is the #777 most-billed Medicaid procedure code, with $84.1M in payments across 30K claims from 2018–2024. The national median cost per claim is $2,705.30. Costs vary widely — the 90th percentile is $5,462.90 per claim, 2.0× the median.
Total Paid
$84.1M
0.01% of all spending
Total Claims
30K
Providers
85
Avg Cost/Claim
$3K
National Cost Distribution
How much do providers bill per claim for J9312? Based on 80 providers billing this code nationally.
Median
$2,705.30
Average
$2,992.79
Std Dev
$1,911.53
Max
$8,925.00
Percentile Distribution (Cost per Claim)
50% of providers bill between $1,471.40 and $4,536.70 per claim for this code.
90% bill between $688.90 and $5,462.90.
Top 1% bill above $7,589.82.
About This Procedure
HCPCS code J9312 was billed by 85 providers across 30K claims, totaling $84.1M 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
$2,705.30
Providers Billing
80
National Spending
$84.1M
Avg/Median Ratio
1.11×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for J9312
| # | Provider | Total Paid |
|---|---|---|
| 1 | Yale New Haven Hospital New Haven, CT · General Acute Care Hospital | $8.5M |
| 2 | Hmh Hospitals Corporation Hackensack, NJ · Ambulance | $7.1M |
| 3 | Alivia Specialty Llc Guaynabo, PR · Pharmacy Specialty Pharmacy | $6.2M |
| 4 | 1003989831 | $5.5M |
| 5 | Unm Hospital Albuquerque, NM · General Acute Care Hospital | $3.9M |
| 6 | Seventh-day Adventists Loma Linda University Medical Center Loma Linda, CA · General Acute Care Hospital | $3.4M |
| 7 | 1265462659 | $2.7M |
| 8 | The General Hospital Corporation Boston, MA · General Acute Care Hospital | $2.6M |
| 9 | Regents Of The University Of California San Diego, CA · General Acute Care Hospital | $2.5M |
| 10 | 1437230034 | $2.5M |
| 11 | Regents Of The University Of Michigan Ann Arbor, MI · Clinic/Center, End-Stage Renal Disease (ESRD) Treatment | $2.5M |
| 12 | State Of Mississippi - University Of Mississippi Medical Center Jackson, MS · General Acute Care Hospital | $2.3M |
| 13 | 1427536325 | $2.3M |
| 14 | The New York And Presbyterian Hospital New York, NY · General Acute Care Hospital | $2.1M |
| 15 | University Of California Irvine Orange, CA · General Acute Care Hospital | $1.9M |
| 16 | Egleston Children's Hospital At Emory University Inc. Atlanta, GA · Pediatrics Pediatric Emergency Medicine | $1.6M |
| 17 | Umass Memorial Medical Center, Inc. Worcester, MA · General Acute Care Hospital | $1.6M |
| 18 | University Of Kentucky Lexington, KY · General Acute Care Hospital | $1.5M |
| 19 | Riverside University Health Systems - Medical Center Moreno Valley, CA · General Acute Care Hospital | $1.4M |
| 20 | 1477549756 | $1.3M |
Showing top 20 of 85 providers billing this code