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#2876 of 11K

01938

HCPCS Procedure Code

HCPCS code 01938 is the #2,876 most-billed Medicaid procedure code, with $3.2M in payments across 55K claims from 2018–2024. The national median cost per claim is $46.15. Costs vary widely — the 90th percentile is $110.15 per claim, 2.4× the median.

Total Paid

$3.2M

0.00% of all spending

Total Claims

55K

Providers

128

Avg Cost/Claim

$58

National Cost Distribution

How much do providers bill per claim for 01938? Based on 126 providers billing this code nationally.

Median

$46.15

Average

$66.15

Std Dev

$98.85

Max

$947.01

Percentile Distribution (Cost per Claim)

p10
$13.67
p25
$28.31
Median
$46.15
p75
$78.61
p90
$110.15
p95
$124.87
p99
$482.91

50% of providers bill between $28.31 and $78.61 per claim for this code.

90% bill between $13.67 and $110.15.

Top 1% bill above $482.91.

About This Procedure

HCPCS code 01938 was billed by 128 providers across 55K claims, totaling $3.2M in Medicaid payments from 2018–2024. This code was used for 45K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$46.15

Providers Billing

126

National Spending

$3.2M

Avg/Median Ratio

1.43×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 01938

#ProviderTotal Paid
11336528926$251K
21710683412$212K
31790920452$192K
41710110499$192K
51265435416$180K
61134478209$160K
71992129365$148K
81336530997$139K
91447207147$134K
101619278439$128K
111063880052$122K
121982914370$94K
131942736285$75K
141700030939$75K
151629544622$75K
161740403658$73K
171952775975$68K
181245623834$59K
191508285776$55K
201114378874$42K

Showing top 20 of 128 providers billing this code