#3298 of 11K

0361

HCPCS Procedure Code

HCPCS code 0361 is the #3,298 most-billed Medicaid procedure code, with $2.0M in payments across 72K claims from 2018–2024. The national median cost per claim is $102.41.

Total Paid

$2.0M

0.00% of all spending

Total Claims

72K

Providers

Avg Cost/Claim

$27

National Cost Distribution

How much do providers bill per claim for 0361? Based on 24 providers billing this code nationally.

Median

$102.41

Average

$100.01

Std Dev

$72.29

Max

$266.88

Percentile Distribution (Cost per Claim)

p10

$13.54

p25

$25.41

Median

$102.41

p75

$155.65

p90

$177.25

p95

$182.46

p99

$247.48

50% of providers bill between $25.41 and $155.65 per claim for this code.

90% bill between $13.54 and $177.25.

Top 1% bill above $247.48.

About This Procedure

HCPCS code 0361 was billed by 40 providers across 72K claims, totaling $2.0M in Medicaid payments from 2018–2024. This code was used for 59K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$102.41

Providers Billing

National Spending

$2.0M

Avg/Median Ratio

0.98×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 0361

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1013981554	$555K	$182.52	1.8× median	Top 10%
2	1538163886	$268K	$182.11	1.8× median	Top 10%
3	1871606269	$195K	$165.89	1.6× median	Above 75th
4	County Of Santa Clara San Jose, CA · Case Manager/Care Coordinator	$191K	$3.58	0.0× median	Below Median
5	1417901091	$158K	$164.78	1.6× median	Above 75th
6	1811080526	$138K	$26.92	0.3× median	Below Median
7	Seventh-day Adventists Loma Linda University Medical Center Loma Linda, CA · General Acute Care Hospital	$133K	$160.23	1.6× median	Above 75th
8	City & County Of San Francisco San Francisco, CA · Case Manager/Care Coordinator	$95K	$143.68	1.4× median	Above Median
9	Keck Medical Center Of Usc Los Angeles, CA · General Acute Care Hospital	$79K	$266.88	2.6× median	Top 1%
10	1073519443	$64K	$148.13	1.4× median	Above Median
11	1952476525	$47K	$126.41	1.2× median	Above Median
12	1578529285	$14K	$13.40	0.1× median	Below Median
13	1821442864	$11K	$26.78	0.3× median	Below Median
14	1710109186	$8K	$122.32	1.2× median	Above Median
15	Riverside University Health Systems - Medical Center Moreno Valley, CA · General Acute Care Hospital	$7K	$105.86	1.0× median	Above Median
16	1437122769	$5K	$98.33	1.0× median	Below Median
17	1962442012	$3K	$98.95	1.0× median	Below Median
18	1194711952	$3K	$21.30	0.2× median	Below Median
19	1477587632	$3K	$84.44	0.8× median	Below Median
20	Sutter Valley Hospitals Sacramento, CA · Psychiatric Hospital	$2K	$154.13	1.5× median	Above Median

Showing top 20 of 40 providers billing this code

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