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

#2975 of 11K

0171

HCPCS Procedure Code

HCPCS code 0171 is the #2,975 most-billed Medicaid procedure code, with $2.9M in payments across 10K claims from 2018–2024. The national median cost per claim is $209.20. Costs vary widely — the 90th percentile is $1,101.82 per claim, 5.3× the median.

Total Paid

$2.9M

0.00% of all spending

Total Claims

10K

Providers

35

Avg Cost/Claim

$279

National Cost Distribution

How much do providers bill per claim for 0171? Based on 27 providers billing this code nationally.

Median

$209.20

Average

$407.29

Std Dev

$559.08

Max

$2,452.94

Percentile Distribution (Cost per Claim)

p10
$7.76
p25
$30.65
Median
$209.20
p75
$456.84
p90
$1,101.82
p95
$1,416.05
p99
$2,191.40

50% of providers bill between $30.65 and $456.84 per claim for this code.

90% bill between $7.76 and $1,101.82.

Top 1% bill above $2,191.40.

About This Procedure

HCPCS code 0171 was billed by 35 providers across 10K claims, totaling $2.9M in Medicaid payments from 2018–2024. This code was used for 10K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$209.20

Providers Billing

27

National Spending

$2.9M

Avg/Median Ratio

1.95×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for 0171

#ProviderTotal Paid
1Desert Valley Hospital Llc

Victorville, CA · General Acute Care Hospital

$1.1M
2Palomar Health

Escondido, CA · General Acute Care Hospital

$406K
31114547114$223K
41336328244$171K
51922033547$166K
61235120676$162K
71740215219$145K
81518940667$98K
91073519443$93K
101093892275$78K
111639523004$77K
121932197258$42K
131982629440$40K
141194840421$22K
151578529285$18K
161821250762$15K
171811129752$6K
181336173269$5K
191215927470$4K
20County Of Santa Clara

San Jose, CA · Case Manager/Care Coordinator

$3K

Showing top 20 of 35 providers billing this code