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#2679 of 11K

0561

HCPCS Procedure Code

HCPCS code 0561 is the #2,679 most-billed Medicaid procedure code, with $4.2M in payments across 25K claims from 2018–2024. The national median cost per claim is $123.61.

Total Paid

$4.2M

0.00% of all spending

Total Claims

25K

Providers

17

Avg Cost/Claim

$167

National Cost Distribution

How much do providers bill per claim for 0561? Based on 11 providers billing this code nationally.

Median

$123.61

Average

$140.35

Std Dev

$155.92

Max

$561.63

Percentile Distribution (Cost per Claim)

p10
$15.17
p25
$38.09
Median
$123.61
p75
$149.24
p90
$224.65
p95
$393.14
p99
$527.94

50% of providers bill between $38.09 and $149.24 per claim for this code.

90% bill between $15.17 and $224.65.

Top 1% bill above $527.94.

About This Procedure

HCPCS code 0561 was billed by 17 providers across 25K claims, totaling $4.2M in Medicaid payments from 2018–2024. This code was used for 14K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$123.61

Providers Billing

11

National Spending

$4.2M

Avg/Median Ratio

1.14×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 0561

#ProviderTotal Paid
11992779417$1.6M
21992012306$1.4M
3Northern Valley Indian Health Inc

Willows, CA · Clinic/Center

$581K
41194899138$371K
51245356674$116K
61629130240$73K
71093801680$28K
81619952397$17K
91225184963$14K
101659433191$5K
11Chapa-de Indian Health Program Inc.

Auburn, CA · Clinic/Center Federally Qualified Health Center (FQHC)

$15
121255779187$0
131922006162$0
141821134040$0
151609044924$0
161588826374$0
171922138841$0

Showing top 17 of 17 providers billing this code