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#4451 of 11K

0305

HCPCS Procedure Code

HCPCS code 0305 is the #4,451 most-billed Medicaid procedure code, with $583K in payments across 298K claims from 2018–2024. The national median cost per claim is $0.46. Costs vary widely — the 90th percentile is $34.92 per claim, 75.9× the median.

Total Paid

$583K

0.00% of all spending

Total Claims

298K

Providers

160

Avg Cost/Claim

$2

National Cost Distribution

How much do providers bill per claim for 0305? Based on 71 providers billing this code nationally.

Median

$0.46

Average

$22.28

Std Dev

$73.33

Max

$476.31

Percentile Distribution (Cost per Claim)

p10
$0.01
p25
$0.04
Median
$0.46
p75
$6.28
p90
$34.92
p95
$87.33
p99
$400.41

50% of providers bill between $0.04 and $6.28 per claim for this code.

90% bill between $0.01 and $34.92.

Top 1% bill above $400.41.

About This Procedure

HCPCS code 0305 was billed by 160 providers across 298K claims, totaling $583K in Medicaid payments from 2018–2024. This code was used for 231K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$0.46

Providers Billing

71

National Spending

$583K

Avg/Median Ratio

48.43×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for 0305

#ProviderTotal Paid
11194711952$131K
21760510937$73K
31639523004$66K
41710065933$54K
51295181477$28K
61578529285$27K
71659439834$25K
81265468946$25K
9Regents Of The University Of California

Sacramento, CA · General Acute Care Hospital

$23K
101639172372$14K
111124004304$14K
121881760452$13K
131477554152$11K
141972541498$10K
15Kaiser Foundation Health Plan Inc

Oakland, CA · Health Maintenance Organization

$10K
161902803315$10K
171245371343$8K
181902844988$6K
191528263746$5K
201811080526$4K

Showing top 20 of 160 providers billing this code