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

#2488 of 11K

J9354

HCPCS Procedure Code

HCPCS code J9354 is the #2,488 most-billed Medicaid procedure code, with $5.4M in payments across 1K claims from 2018–2024. The national median cost per claim is $3,182.82.

Total Paid

$5.4M

0.00% of all spending

Total Claims

1K

Providers

4

Avg Cost/Claim

$5K

National Cost Distribution

How much do providers bill per claim for J9354? Based on 4 providers billing this code nationally.

Median

$3,182.82

Average

$3,699.32

Std Dev

$2,138.73

Max

$6,719.75

Percentile Distribution (Cost per Claim)

p10
$2,080.88
p25
$2,634.38
Median
$3,182.82
p75
$4,247.76
p90
$5,730.95
p95
$6,225.35
p99
$6,620.87

50% of providers bill between $2,634.38 and $4,247.76 per claim for this code.

90% bill between $2,080.88 and $5,730.95.

Top 1% bill above $6,620.87.

About This Procedure

HCPCS code J9354 was billed by 4 providers across 1K claims, totaling $5.4M in Medicaid payments from 2018–2024. This code was used for 560 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

$3,182.82

Providers Billing

4

National Spending

$5.4M

Avg/Median Ratio

1.16×

Normal distribution

Provider Coverage

We have 4 providers billing this code in our dataset. Individual provider breakdowns are available for top-spending procedure codes.