0431
HCPCS Procedure Code
HCPCS code 0431 is the #2,615 most-billed Medicaid procedure code, with $4.6M in payments across 31K claims from 2018–2024. The national median cost per claim is $118.46.
Total Paid
$4.6M
0.00% of all spending
Total Claims
31K
Providers
24
Avg Cost/Claim
$145
National Cost Distribution
How much do providers bill per claim for 0431? Based on 17 providers billing this code nationally.
Median
$118.46
Average
$187.37
Std Dev
$394.25
Max
$1,700.17
Percentile Distribution (Cost per Claim)
50% of providers bill between $51.65 and $138.45 per claim for this code.
90% bill between $10.44 and $172.63.
Top 1% bill above $1,460.92.
About This Procedure
HCPCS code 0431 was billed by 24 providers across 31K claims, totaling $4.6M in Medicaid payments from 2018–2024. This code was used for 11K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$118.46
Providers Billing
17
National Spending
$4.6M
Avg/Median Ratio
1.58×
Moderately skewed
Top Providers Billing This Code
Ranked by total Medicaid payments for 0431
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1194899138 | $3.3M |
| 2 | 1629371398 | $585K |
| 3 | 1689715674 | $225K |
| 4 | 1962474387 | $175K |
| 5 | 1275739047 | $144K |
| 6 | 1225184963 | $62K |
| 7 | 1821043332 | $29K |
| 8 | 1154387926 | $19K |
| 9 | 1093801680 | $16K |
| 10 | 1841291002 | $9K |
| 11 | 1184804825 | $8K |
| 12 | 1477560035 | $8K |
| 13 | 1063726628 | $6K |
| 14 | 1114927985 | $757 |
| 15 | 1700890514 | $535 |
| 16 | 1649275868 | $357 |
| 17 | 1760724231 | $71 |
| 18 | 1871141937 | $0 |
| 19 | 1205835873 | $0 |
| 20 | 1396082004 | $0 |
Showing top 20 of 24 providers billing this code