Statistical flags indicate unusual patterns — not proof of fraud or wrongdoing. Read our methodology

#5904 of 11K

0391

HCPCS Procedure Code

HCPCS code 0391 is the #5,904 most-billed Medicaid procedure code, with $121K in payments across 4K claims from 2018–2024. The national median cost per claim is $32.37. Costs vary widely — the 90th percentile is $219.95 per claim, 6.8× the median.

Total Paid

$121K

0.00% of all spending

Total Claims

4K

Providers

11

Avg Cost/Claim

$33

National Cost Distribution

How much do providers bill per claim for 0391? Based on 8 providers billing this code nationally.

Median

$32.37

Average

$84.62

Std Dev

$110.20

Max

$315.03

Percentile Distribution (Cost per Claim)

p10
$2.58
p25
$18.56
Median
$32.37
p75
$112.78
p90
$219.95
p95
$267.49
p99
$305.52

50% of providers bill between $18.56 and $112.78 per claim for this code.

90% bill between $2.58 and $219.95.

Top 1% bill above $305.52.

About This Procedure

HCPCS code 0391 was billed by 11 providers across 4K claims, totaling $121K in Medicaid payments from 2018–2024. This code was used for 3K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$32.37

Providers Billing

8

National Spending

$121K

Avg/Median Ratio

2.61×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for 0391

#ProviderTotal Paid
1City Of Hope National Medical Center

Duarte, CA · General Acute Care Hospital

$100K
2County Of Santa Clara

San Jose, CA · Case Manager/Care Coordinator

$10K
31417901091$6K
41811946734$3K
51104906569$978
61114547114$612
71710109186$488
81558575746$68
91578529285$0
101922033547$0
111821002007$0

Showing top 11 of 11 providers billing this code