0424
HCPCS Procedure Code
HCPCS code 0424 is the #5,978 most-billed Medicaid procedure code, with $111K in payments across 8K claims from 2018–2024. The national median cost per claim is $14.82. Costs vary widely — the 90th percentile is $126.59 per claim, 8.5× the median.
Total Paid
$111K
0.00% of all spending
Total Claims
8K
Providers
48
Avg Cost/Claim
$14
National Cost Distribution
How much do providers bill per claim for 0424? Based on 18 providers billing this code nationally.
Median
$14.82
Average
$43.73
Std Dev
$53.53
Max
$137.68
Percentile Distribution (Cost per Claim)
50% of providers bill between $3.27 and $96.66 per claim for this code.
90% bill between $0.74 and $126.59.
Top 1% bill above $136.43.
About This Procedure
HCPCS code 0424 was billed by 48 providers across 8K claims, totaling $111K in Medicaid payments from 2018–2024. This code was used for 8K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$14.82
Providers Billing
18
National Spending
$111K
Avg/Median Ratio
2.95×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for 0424
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1093801680 | $64K |
| 2 | 1194840421 | $15K |
| 3 | County Of Ventura Ventura, CA · Clinic/Center, Emergency Care | $8K |
| 4 | 1821043332 | $7K |
| 5 | 1831144716 | $4K |
| 6 | 1578529285 | $3K |
| 7 | 1831188275 | $2K |
| 8 | 1861451841 | $2K |
| 9 | 1487681631 | $2K |
| 10 | Kaiser Foundation Health Plan Inc Oakland, CA · Health Maintenance Organization | $927 |
| 11 | Childrens Hospital Of Los Angeles Los Angeles, CA · Case Manager/Care Coordinator | $884 |
| 12 | 1700890514 | $620 |
| 13 | Regents Of The University Of California Sacramento, CA · General Acute Care Hospital | $597 |
| 14 | 1760510937 | $349 |
| 15 | 1497748081 | $173 |
| 16 | 1194099127 | $165 |
| 17 | 1164429684 | $103 |
| 18 | 1336328244 | $26 |
| 19 | 1073665360 | $0 |
| 20 | 1326297078 | $0 |
Showing top 20 of 48 providers billing this code