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#3751 of 11K

0258

HCPCS Procedure Code

HCPCS code 0258 is the #3,751 most-billed Medicaid procedure code, with $1.2M in payments across 203K claims from 2018–2024. The national median cost per claim is $2.10. Costs vary widely — the 90th percentile is $23.07 per claim, 11.0× the median.

Total Paid

$1.2M

0.00% of all spending

Total Claims

203K

Providers

182

Avg Cost/Claim

$6

National Cost Distribution

How much do providers bill per claim for 0258? Based on 133 providers billing this code nationally.

Median

$2.10

Average

$9.27

Std Dev

$19.11

Max

$113.79

Percentile Distribution (Cost per Claim)

p10
$0.04
p25
$0.25
Median
$2.10
p75
$8.07
p90
$23.07
p95
$48.32
p99
$100.98

50% of providers bill between $0.25 and $8.07 per claim for this code.

90% bill between $0.04 and $23.07.

Top 1% bill above $100.98.

About This Procedure

HCPCS code 0258 was billed by 182 providers across 203K claims, totaling $1.2M in Medicaid payments from 2018–2024. This code was used for 163K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$2.10

Providers Billing

133

National Spending

$1.2M

Avg/Median Ratio

4.41×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for 0258

#ProviderTotal Paid
11902803315$140K
21710065933$135K
3Grossmont Hospital Corporation

La Mesa, CA · General Acute Care Hospital

$96K
4Sharp Chula Vista Medical Center

Chula Vista, CA · General Acute Care Hospital

$91K
51215903018$71K
6Sharp Memorial Hospital

San Diego, CA · General Acute Care Hospital, Women

$61K
71831188275$55K
81245371343$47K
91417089350$37K
101780614685$37K
111639523004$33K
12Palomar Health

Escondido, CA · General Acute Care Hospital

$28K
131467459776$25K
14Kaiser Foundation Hospitals

Downey, CA · General Acute Care Hospital

$23K
151659439834$22K
161659359446$21K
171780676221$20K
181073519443$19K
19County Of Ventura

Ventura, CA · Clinic/Center, Emergency Care

$16K
201265468946$15K

Showing top 20 of 182 providers billing this code