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#2828 of 11K

0113

HCPCS Procedure Code

HCPCS code 0113 is the #2,828 most-billed Medicaid procedure code, with $3.5M in payments across 3K claims from 2018–2024. The national median cost per claim is $1,005.24. Costs vary widely — the 90th percentile is $5,174.93 per claim, 5.1× the median.

Total Paid

$3.5M

0.00% of all spending

Total Claims

3K

Providers

5

Avg Cost/Claim

$1K

National Cost Distribution

How much do providers bill per claim for 0113? Based on 4 providers billing this code nationally.

Median

$1,005.24

Average

$2,155.00

Std Dev

$3,074.18

Max

$6,584.38

Percentile Distribution (Cost per Claim)

p10
$54.88
p25
$99.50
Median
$1,005.24
p75
$3,060.74
p90
$5,174.93
p95
$5,879.66
p99
$6,443.44

50% of providers bill between $99.50 and $3,060.74 per claim for this code.

90% bill between $54.88 and $5,174.93.

Top 1% bill above $6,443.44.

About This Procedure

HCPCS code 0113 was billed by 5 providers across 3K claims, totaling $3.5M in Medicaid payments from 2018–2024. This code was used for 3K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$1,005.24

Providers Billing

4

National Spending

$3.5M

Avg/Median Ratio

2.14×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for 0113

#ProviderTotal Paid
11710065933$3.3M
2Kaiser Foundation Health Plan Inc

Oakland, CA · Health Maintenance Organization

$145K
31124173059$23K
41699986331$5K
51669617197$0

Showing top 5 of 5 providers billing this code