#3813 of 11K

01940

HCPCS Procedure Code

HCPCS code 01940 is the #3,813 most-billed Medicaid procedure code, with $1.1M in payments across 18K claims from 2018–2024. The national median cost per claim is $57.16.

Total Paid

$1.1M

0.00% of all spending

Total Claims

18K

Providers

Avg Cost/Claim

$63

National Cost Distribution

How much do providers bill per claim for 01940? Based on 66 providers billing this code nationally.

Median

$57.16

Average

$80.58

Std Dev

$102.52

Max

$636.18

Percentile Distribution (Cost per Claim)

p10

$25.85

p25

$43.64

Median

$57.16

p75

$82.26

p90

$105.49

p95

$150.48

p99

$533.52

50% of providers bill between $43.64 and $82.26 per claim for this code.

90% bill between $25.85 and $105.49.

Top 1% bill above $533.52.

About This Procedure

HCPCS code 01940 was billed by 68 providers across 18K claims, totaling $1.1M in Medicaid payments from 2018–2024. This code was used for 15K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$57.16

Providers Billing

National Spending

$1.1M

Avg/Median Ratio

1.41×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 01940

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1871650739	$163K	$72.62	1.3× median	Above Median
2	1710683412	$109K	$80.83	1.4× median	Above Median
3	1336528926	$77K	$45.11	0.8× median	Below Median
4	1639418858	$58K	$94.68	1.7× median	Above 75th
5	1891740296	$55K	$94.24	1.6× median	Above 75th
6	1790920452	$52K	$45.48	0.8× median	Below Median
7	1306280177	$49K	$57.58	1.0× median	Above Median
8	1134762040	$44K	$59.20	1.0× median	Above Median
9	1508133497	$42K	$38.90	0.7× median	Below Median
10	1790384071	$42K	$57.64	1.0× median	Above Median
11	1114524147	$37K	$51.89	0.9× median	Below Median
12	1992129365	$37K	$636.18	11.1× median	Top 1%
13	1336319086	$32K	$84.06	1.5× median	Above 75th
14	1649362740	$30K	$68.09	1.2× median	Above Median
15	1700030939	$27K	$108.36	1.9× median	Top 10%
16	1184284291	$24K	$45.98	0.8× median	Below Median
17	1942736285	$20K	$44.41	0.8× median	Below Median
18	1154826873	$18K	$95.25	1.7× median	Above 75th
19	1336358571	$14K	$43.39	0.8× median	Below Median
20	1710110499	$13K	$29.41	0.5× median	Below Median

Showing top 20 of 68 providers billing this code

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