Statistical flags indicate unusual patterns — not proof of fraud or wrongdoing. Read our methodology

#3860 of 11K

J9317

HCPCS Procedure Code

HCPCS code J9317 is the #3,860 most-billed Medicaid procedure code, with $1.1M in payments across 124 claims from 2018–2024. The national median cost per claim is $7,191.53.

Total Paid

$1.1M

0.00% of all spending

Total Claims

124

Providers

2

Avg Cost/Claim

$9K

National Cost Distribution

How much do providers bill per claim for J9317? Based on 2 providers billing this code nationally.

Median

$7,191.53

Average

$7,191.53

Std Dev

$9,259.69

Max

$13,739.12

Percentile Distribution (Cost per Claim)

p10
$1,953.46
p25
$3,917.74
Median
$7,191.53
p75
$10,465.32
p90
$12,429.60
p95
$13,084.36
p99
$13,608.16

50% of providers bill between $3,917.74 and $10,465.32 per claim for this code.

90% bill between $1,953.46 and $12,429.60.

Top 1% bill above $13,608.16.

About This Procedure

HCPCS code J9317 was billed by 2 providers across 124 claims, totaling $1.1M in Medicaid payments from 2018–2024. This code was used for 66 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

$7,191.53

Providers Billing

2

National Spending

$1.1M

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.