#3834 of 11K

J9370

HCPCS Procedure Code

HCPCS code J9370 is the #3,834 most-billed Medicaid procedure code, with $1.1M in payments across 135K claims from 2018–2024. The national median cost per claim is $7.57. Costs vary widely — the 90th percentile is $21.46 per claim, 2.8× the median.

Total Paid

$1.1M

0.00% of all spending

Total Claims

135K

Providers

141

Avg Cost/Claim

National Cost Distribution

How much do providers bill per claim for J9370? Based on 121 providers billing this code nationally.

Median

$7.57

Average

$14.21

Std Dev

$34.79

Max

$327.61

Percentile Distribution (Cost per Claim)

p10

$0.37

p25

$1.92

Median

$7.57

p75

$12.83

p90

$21.46

p95

$39.34

p99

$149.57

50% of providers bill between $1.92 and $12.83 per claim for this code.

90% bill between $0.37 and $21.46.

Top 1% bill above $149.57.

About This Procedure

HCPCS code J9370 was billed by 141 providers across 135K claims, totaling $1.1M in Medicaid payments from 2018–2024. This code was used for 87K 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

$7.57

Providers Billing

121

National Spending

$1.1M

Avg/Median Ratio

1.88×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for J9370

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	Arkansas Childrens Hospital Little Rock, AR · Clinic/Center, Critical Access Hospital	$150K	$36.67	4.8× median	Top 10%
2	Childrens Hospital Of Los Angeles Los Angeles, CA · Case Manager/Care Coordinator	$85K	$12.16	1.6× median	Above Median
3	1811080526	$66K	$13.76	1.8× median	Above 75th
4	Scottish Rite Children's Medical Center Atlanta, GA · Pediatrics Pediatric Hematology-Oncology	$66K	$9.79	1.3× median	Above Median
5	1700949336	$48K	$13.41	1.8× median	Above 75th
6	Egleston Children's Hospital At Emory University Inc. Atlanta, GA · Pediatrics Pediatric Emergency Medicine	$45K	$12.30	1.6× median	Above Median
7	Loma Linda University Children's Hospital Loma Linda, CA · General Acute Care Hospital Children	$42K	$13.39	1.8× median	Above 75th
8	Memorial Hospital For Cancer And Allied Diseases New York, NY · Pharmacy	$36K	$27.45	3.6× median	Top 10%
9	Childrens Hospital Of Philadelphia Philadelphia, PA · General Acute Care Hospital Children	$34K	$12.64	1.7× median	Above Median
10	Rhode Island Hospital Providence, RI · General Acute Care Hospital	$33K	$327.61	43.3× median	Top 1%
11	Long Island Jewish Medical Center New Hyde Park, NY · General Acute Care Hospital	$28K	$9.86	1.3× median	Above Median
12	Dana-farber Cancer Institute, Inc. Boston, MA · General Acute Care Hospital	$25K	$4.33	0.6× median	Below Median
13	Hmh Hospitals Corporation Hackensack, NJ · Ambulance	$25K	$12.83	1.7× median	Above Median
14	1467442749	$23K	$20.50	2.7× median	Above 75th
15	Children's Health System Of Texas Dallas, TX · General Acute Care Hospital Children	$21K	$164.45	21.7× median	Top 1%
16	1346297843	$20K	$65.62	8.7× median	Top 10%
17	Montefiore Medical Center Bronx, NY · General Acute Care Hospital	$17K	$9.01	1.2× median	Above Median
18	Unm Hospital Albuquerque, NM · General Acute Care Hospital	$17K	$14.43	1.9× median	Above 75th
19	University Of Kentucky Lexington, KY · General Acute Care Hospital	$16K	$6.25	0.8× median	Below Median
20	Carolinas Medical Center Charlotte, NC · General Acute Care Hospital	$14K	$73.19	9.7× median	Top 10%

Showing top 20 of 141 providers billing this code

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