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

#8265 of 11K

J9394

HCPCS Procedure Code

HCPCS code J9394 is the #8,265 most-billed Medicaid procedure code, with $4K in payments across 175 claims from 2018–2024. The national median cost per claim is $43.01.

Total Paid

$4K

0.00% of all spending

Total Claims

175

Providers

4

Avg Cost/Claim

$25

National Cost Distribution

How much do providers bill per claim for J9394? Based on 4 providers billing this code nationally.

Median

$43.01

Average

$40.60

Std Dev

$32.85

Max

$76.39

Percentile Distribution (Cost per Claim)

p10
$9.25
p25
$23.11
Median
$43.01
p75
$60.49
p90
$70.03
p95
$73.21
p99
$75.76

50% of providers bill between $23.11 and $60.49 per claim for this code.

90% bill between $9.25 and $70.03.

Top 1% bill above $75.76.

About This Procedure

HCPCS code J9394 was billed by 4 providers across 175 claims, totaling $4K in Medicaid payments from 2018–2024. This code was used for 134 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

$43.01

Providers Billing

4

National Spending

$4K

Avg/Median Ratio

0.94×

Normal distribution

Provider Coverage

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