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#7529 of 11K

0174A

HCPCS Procedure Code

HCPCS code 0174A is the #7,529 most-billed Medicaid procedure code, with $15K in payments across 249 claims from 2018–2024. The national median cost per claim is $37.99. Costs vary widely — the 90th percentile is $324.85 per claim, 8.6× the median.

Total Paid

$15K

0.00% of all spending

Total Claims

249

Providers

6

Avg Cost/Claim

$62

National Cost Distribution

How much do providers bill per claim for 0174A? Based on 6 providers billing this code nationally.

Median

$37.99

Average

$125.84

Std Dev

$234.49

Max

$603.69

Percentile Distribution (Cost per Claim)

p10
$14.68
p25
$24.07
Median
$37.99
p75
$44.52
p90
$324.85
p95
$464.27
p99
$575.81

50% of providers bill between $24.07 and $44.52 per claim for this code.

90% bill between $14.68 and $324.85.

Top 1% bill above $575.81.

About This Procedure

HCPCS code 0174A was billed by 6 providers across 249 claims, totaling $15K in Medicaid payments from 2018–2024. This code was used for 218 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$37.99

Providers Billing

6

National Spending

$15K

Avg/Median Ratio

3.31×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for 0174A

#ProviderTotal Paid
1Dhhs,phs,naihs, Gallup Indian Medical Center

Gallup, NM · General Acute Care Hospital

$8K
2Children's Hospital Medical Center

Cincinnati, OH · Clinic/Center, Primary Care

$3K
31417004003$2K
41114027331$1K
5Boston Medical Center Corporation

Boston, MA · General Acute Care Hospital

$826
61962520288$240

Showing top 6 of 6 providers billing this code