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#4743 of 11K

0278

HCPCS Procedure Code

HCPCS code 0278 is the #4,743 most-billed Medicaid procedure code, with $423K in payments across 6K claims from 2018–2024. The national median cost per claim is $17.55. Costs vary widely — the 90th percentile is $481.88 per claim, 27.5× the median.

Total Paid

$423K

0.00% of all spending

Total Claims

6K

Providers

35

Avg Cost/Claim

$65

National Cost Distribution

How much do providers bill per claim for 0278? Based on 17 providers billing this code nationally.

Median

$17.55

Average

$496.42

Std Dev

$1,656.55

Max

$6,885.62

Percentile Distribution (Cost per Claim)

p10
$1.10
p25
$5.59
Median
$17.55
p75
$59.19
p90
$481.88
p95
$1,927.72
p99
$5,894.04

50% of providers bill between $5.59 and $59.19 per claim for this code.

90% bill between $1.10 and $481.88.

Top 1% bill above $5,894.04.

About This Procedure

HCPCS code 0278 was billed by 35 providers across 6K claims, totaling $423K in Medicaid payments from 2018–2024. This code was used for 6K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$17.55

Providers Billing

17

National Spending

$423K

Avg/Median Ratio

28.29×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for 0278

#ProviderTotal Paid
11215927470$273K
21518940667$96K
31063441293$13K
41184628919$11K
51336328244$7K
61750365375$6K
71477610640$6K
81073665360$3K
91982629440$3K
10Stanford Health Care

Stanford, CA · General Acute Care Hospital

$2K
111760510937$362
121578529285$307
131114081056$292
141417901091$168
151417089350$128
161952777245$54
171073519443$14
181114547114$0
191518951300$0
201124173059$0

Showing top 20 of 35 providers billing this code