12013
HCPCS Procedure Code
HCPCS code 12013 is the #4,522 most-billed Medicaid procedure code, with $534K in payments across 8K claims from 2018–2024. The national median cost per claim is $63.36. Costs vary widely — the 90th percentile is $281.12 per claim, 4.4× the median.
Total Paid
$534K
0.00% of all spending
Total Claims
8K
Providers
88
Avg Cost/Claim
$66
National Cost Distribution
How much do providers bill per claim for 12013? Based on 78 providers billing this code nationally.
Median
$63.36
Average
$106.30
Std Dev
$115.58
Max
$561.02
Percentile Distribution (Cost per Claim)
50% of providers bill between $33.01 and $138.76 per claim for this code.
90% bill between $10.57 and $281.12.
Top 1% bill above $480.46.
About This Procedure
HCPCS code 12013 was billed by 88 providers across 8K claims, totaling $534K in Medicaid payments from 2018–2024. This code was used for 8K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$63.36
Providers Billing
78
National Spending
$534K
Avg/Median Ratio
1.68×
Moderately skewed
Top Providers Billing This Code
Ranked by total Medicaid payments for 12013
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1093756025 | $62K |
| 2 | St. Barnabas Hospital Bronx, NY · General Acute Care Hospital | $56K |
| 3 | 1902855711 | $27K |
| 4 | The Brookdale Hospital Medical Center Brooklyn, NY · General Acute Care Hospital | $24K |
| 5 | Montefiore Medical Center Bronx, NY · General Acute Care Hospital | $21K |
| 6 | Maricopa County Special Health Care District Phoenix, AZ · General Acute Care Hospital | $17K |
| 7 | Presbyterian Healthcare Services Albuquerque, NM · Emergency Medicine | $17K |
| 8 | Ohiohealth Corporation Columbus, OH · General Acute Care Hospital | $17K |
| 9 | Aurora Health Care Metro, Inc. Milwaukee, WI · Internal Medicine, Hematology & Oncology | $16K |
| 10 | Maimonides Medical Center Brooklyn, NY · General Acute Care Hospital | $15K |
| 11 | 1427007384 | $15K |
| 12 | 1225083595 | $14K |
| 13 | The New York And Presbyterian Hospital New York, NY · General Acute Care Hospital | $13K |
| 14 | 1548393127 | $13K |
| 15 | 1861439952 | $11K |
| 16 | San Juan Regional Medical Center, Inc. Farmington, NM · Audiologist | $11K |
| 17 | New York City Health And Hospitals Corporation Bronx, NY · Internal Medicine | $10K |
| 18 | Suny Health Science Center At Syracuse Syracuse, NY · General Acute Care Hospital | $10K |
| 19 | 1265976971 | $10K |
| 20 | 1992281000 | $10K |
Showing top 20 of 88 providers billing this code