12001
HCPCS Procedure Code
HCPCS code 12001 is the #852 most-billed Medicaid procedure code, with $67.3M in payments across 685K claims from 2018–2024. The national median cost per claim is $64.99. Costs vary widely — the 90th percentile is $246.71 per claim, 3.8× the median.
Total Paid
$67.3M
0.01% of all spending
Total Claims
685K
Providers
2K
Avg Cost/Claim
$98
National Cost Distribution
How much do providers bill per claim for 12001? Based on 1K providers billing this code nationally.
Median
$64.99
Average
$106.17
Std Dev
$113.60
Max
$601.93
Percentile Distribution (Cost per Claim)
50% of providers bill between $25.00 and $159.54 per claim for this code.
90% bill between $6.05 and $246.71.
Top 1% bill above $494.96.
About This Procedure
HCPCS code 12001 was billed by 2K providers across 685K claims, totaling $67.3M in Medicaid payments from 2018–2024. This code was used for 654K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$64.99
Providers Billing
1K
National Spending
$67.3M
Avg/Median Ratio
1.63×
Moderately skewed
Top Providers Billing This Code
Ranked by total Medicaid payments for 12001
| # | Provider | Total Paid |
|---|---|---|
| 1 | The New York And Presbyterian Hospital New York, NY · General Acute Care Hospital | $1.0M |
| 2 | Maricopa County Special Health Care District Phoenix, AZ · General Acute Care Hospital | $899K |
| 3 | Montefiore Medical Center Bronx, NY · General Acute Care Hospital | $808K |
| 4 | Rochester General Hospital Rochester, NY · Dentist, General Practice | $790K |
| 5 | Suny Health Science Center At Syracuse Syracuse, NY · General Acute Care Hospital | $749K |
| 6 | Long Island Jewish Medical Center New Hyde Park, NY · General Acute Care Hospital | $703K |
| 7 | University Of Rochester Rochester, NY · General Acute Care Hospital | $652K |
| 8 | 1841231461 | $645K |
| 9 | Children's Hospital Washington, DC · General Acute Care Hospital Children | $625K |
| 10 | Newyork-presbyterian-queens Flushing, NY · General Acute Care Hospital | $623K |
| 11 | 1053373480 | $589K |
| 12 | Samaritan Hospital Of Troy, New York Troy, NY | $579K |
| 13 | Cambridge Public Health Commission Cambridge, MA · General Acute Care Hospital | $578K |
| 14 | Maimonides Medical Center Brooklyn, NY · General Acute Care Hospital | $560K |
| 15 | 1407877137 | $558K |
| 16 | Swedish Health Services Seattle, WA · General Acute Care Hospital | $537K |
| 17 | The Brookdale Hospital Medical Center Brooklyn, NY · General Acute Care Hospital | $534K |
| 18 | Kadlec Regional Medical Center Richland, WA · General Acute Care Hospital | $521K |
| 19 | United Health Services Hospitals, Inc. Binghamton, NY · General Acute Care Hospital | $473K |
| 20 | The New York And Presbyterian Hospital New York, NY · General Acute Care Hospital | $470K |
Showing top 20 of 2K providers billing this code