0260
HCPCS Procedure Code
HCPCS code 0260 is the #4,661 most-billed Medicaid procedure code, with $462K in payments across 19K claims from 2018–2024. The national median cost per claim is $40.53. Costs vary widely — the 90th percentile is $126.86 per claim, 3.1× the median.
Total Paid
$462K
0.00% of all spending
Total Claims
19K
Providers
37
Avg Cost/Claim
$25
National Cost Distribution
How much do providers bill per claim for 0260? Based on 14 providers billing this code nationally.
Median
$40.53
Average
$51.93
Std Dev
$52.36
Max
$152.51
Percentile Distribution (Cost per Claim)
50% of providers bill between $4.16 and $76.87 per claim for this code.
90% bill between $1.04 and $126.86.
Top 1% bill above $150.03.
About This Procedure
HCPCS code 0260 was billed by 37 providers across 19K claims, totaling $462K in Medicaid payments from 2018–2024. This code was used for 10K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$40.53
Providers Billing
14
National Spending
$462K
Avg/Median Ratio
1.28×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for 0260
| # | Provider | Total Paid |
|---|---|---|
| 1 | Palomar Health Escondido, CA · General Acute Care Hospital | $155K |
| 2 | 1902844988 | $123K |
| 3 | 1417901091 | $54K |
| 4 | 1760510937 | $37K |
| 5 | 1508856535 | $35K |
| 6 | 1194711952 | $28K |
| 7 | 1336173269 | $14K |
| 8 | Kaiser Foundation Health Plan Inc Oakland, CA · Health Maintenance Organization | $8K |
| 9 | Regents Of The University Of California Sacramento, CA · General Acute Care Hospital | $6K |
| 10 | 1477554152 | $2K |
| 11 | 1245371343 | $299 |
| 12 | 1225038136 | $159 |
| 13 | 1780668434 | $50 |
| 14 | 1114547114 | $42 |
| 15 | 1982697678 | $0 |
| 16 | 1558575746 | $0 |
| 17 | 1790778488 | $0 |
| 18 | 1952546616 | $0 |
| 19 | University Of California Irvine Orange, CA · General Acute Care Hospital | $0 |
| 20 | 1194926279 | $0 |
Showing top 20 of 37 providers billing this code