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#7319 of 11K

0412

HCPCS Procedure Code

HCPCS code 0412 is the #7,319 most-billed Medicaid procedure code, with $21K in payments across 5K claims from 2018–2024. The national median cost per claim is $13.73. Costs vary widely — the 90th percentile is $29.43 per claim, 2.1× the median.

Total Paid

$21K

0.00% of all spending

Total Claims

5K

Providers

23

Avg Cost/Claim

$4

National Cost Distribution

How much do providers bill per claim for 0412? Based on 9 providers billing this code nationally.

Median

$13.73

Average

$16.62

Std Dev

$11.13

Max

$39.27

Percentile Distribution (Cost per Claim)

p10
$7.00
p25
$13.33
Median
$13.73
p75
$18.89
p90
$29.43
p95
$34.35
p99
$38.28

50% of providers bill between $13.33 and $18.89 per claim for this code.

90% bill between $7.00 and $29.43.

Top 1% bill above $38.28.

About This Procedure

HCPCS code 0412 was billed by 23 providers across 5K claims, totaling $21K in Medicaid payments from 2018–2024. This code was used for 4K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$13.73

Providers Billing

9

National Spending

$21K

Avg/Median Ratio

1.21×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 0412

#ProviderTotal Paid
11871010280$9K
21629377452$6K
31194840421$2K
41487697215$2K
51336163898$818
61841217866$756
71326065103$384
81174911317$179
91760510937$43
10Desert Valley Hospital Llc

Victorville, CA · General Acute Care Hospital

$0
111811129752$0
12Childrens Hospital Of Los Angeles

Los Angeles, CA · Case Manager/Care Coordinator

$0
131689732885$0
141154428688$0
151275578817$0
16Port City Operating Company Llc

Stockton, CA · General Acute Care Hospital

$0
171336328244$0
181477502797$0
191114081056$0
201518951300$0

Showing top 20 of 23 providers billing this code