01916
HCPCS Procedure Code
HCPCS code 01916 is the #4,755 most-billed Medicaid procedure code, with $419K in payments across 13K claims from 2018–2024. The national median cost per claim is $24.17. Costs vary widely — the 90th percentile is $123.41 per claim, 5.1× the median.
Total Paid
$419K
0.00% of all spending
Total Claims
13K
Providers
58
Avg Cost/Claim
$33
National Cost Distribution
How much do providers bill per claim for 01916? Based on 55 providers billing this code nationally.
Median
$24.17
Average
$61.34
Std Dev
$108.96
Max
$765.47
Percentile Distribution (Cost per Claim)
50% of providers bill between $13.55 and $70.84 per claim for this code.
90% bill between $6.82 and $123.41.
Top 1% bill above $462.64.
About This Procedure
HCPCS code 01916 was billed by 58 providers across 13K claims, totaling $419K in Medicaid payments from 2018–2024. This code was used for 10K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$24.17
Providers Billing
55
National Spending
$419K
Avg/Median Ratio
2.54×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for 01916
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1467004556 | $63K |
| 2 | 1871986372 | $45K |
| 3 | 1972928232 | $35K |
| 4 | 1801021464 | $30K |
| 5 | Ohio State University Hospitals Columbus, OH · General Acute Care Hospital | $27K |
| 6 | 1417401266 | $26K |
| 7 | 1972126209 | $21K |
| 8 | 1629091327 | $20K |
| 9 | 1922031442 | $17K |
| 10 | 1033766670 | $15K |
| 11 | 1326093675 | $14K |
| 12 | 1114132370 | $13K |
| 13 | 1548732845 | $9K |
| 14 | 1649264706 | $7K |
| 15 | 1528578333 | $7K |
| 16 | 1629402300 | $7K |
| 17 | 1992133474 | $7K |
| 18 | 1083258362 | $6K |
| 19 | 1881949055 | $4K |
| 20 | 1093707879 | $4K |
Showing top 20 of 58 providers billing this code