#1568 of 11K

00812

HCPCS Procedure Code

HCPCS code 00812 is the #1,568 most-billed Medicaid procedure code, with $18.9M in payments across 313K claims from 2018–2024. The national median cost per claim is $59.54. Costs vary widely — the 90th percentile is $127.02 per claim, 2.1× the median.

Total Paid

$18.9M

0.00% of all spending

Total Claims

313K

Providers

761

Avg Cost/Claim

$60

National Cost Distribution

How much do providers bill per claim for 00812? Based on 719 providers billing this code nationally.

Median

$59.54

Average

$78.75

Std Dev

$136.10

Max

$3,106.13

Percentile Distribution (Cost per Claim)

p10

$23.40

p25

$38.42

Median

$59.54

p75

$90.38

p90

$127.02

p95

$166.71

p99

$388.49

50% of providers bill between $38.42 and $90.38 per claim for this code.

90% bill between $23.40 and $127.02.

Top 1% bill above $388.49.

About This Procedure

HCPCS code 00812 was billed by 761 providers across 313K claims, totaling $18.9M in Medicaid payments from 2018–2024. This code was used for 269K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$59.54

Providers Billing

719

National Spending

$18.9M

Avg/Median Ratio

1.32×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 00812

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1508947441	$1.1M	$111.03	1.9× median	Above 75th
2	1649264706	$609K	$91.94	1.5× median	Above 75th
3	1871986372	$544K	$29.69	0.5× median	Below Median
4	1558612762	$381K	$85.15	1.4× median	Above Median
5	1972126209	$368K	$29.22	0.5× median	Below Median
6	1609804541	$359K	$68.29	1.1× median	Above Median
7	1588938682	$335K	$94.35	1.6× median	Above 75th
8	1356822902	$313K	$86.63	1.5× median	Above Median
9	1073997359	$301K	$50.78	0.9× median	Below Median
10	1891235404	$295K	$779.50	13.1× median	Top 1%
11	1417994872	$294K	$50.84	0.9× median	Below Median
12	1700080777	$293K	$544.66	9.1× median	Top 1%
13	1952392946	$292K	$127.30	2.1× median	Top 10%
14	1205267457	$265K	$79.14	1.3× median	Above Median
15	1376774208	$245K	$88.57	1.5× median	Above Median
16	1447207147	$234K	$85.45	1.4× median	Above Median
17	1982906079	$220K	$147.30	2.5× median	Top 10%
18	1316185390	$218K	$88.40	1.5× median	Above Median
19	1497797153	$211K	$28.73	0.5× median	Below Median
20	1710324041	$206K	$122.48	2.1× median	Above 75th

Showing top 20 of 761 providers billing this code

Related Procedures

0821Revenue code, other laboratory services$185.3M 00811$36.5M 00813$18.5M 00810$6K 00820$299

← All procedures Top providers →