12031
HCPCS Procedure Code
HCPCS code 12031 is the #5,355 most-billed Medicaid procedure code, with $221K in payments across 1K claims from 2018–2024. The national median cost per claim is $141.97.
Total Paid
$221K
0.00% of all spending
Total Claims
1K
Providers
20
Avg Cost/Claim
$169
National Cost Distribution
How much do providers bill per claim for 12031? Based on 17 providers billing this code nationally.
Median
$141.97
Average
$144.85
Std Dev
$105.30
Max
$443.87
Percentile Distribution (Cost per Claim)
50% of providers bill between $69.30 and $186.91 per claim for this code.
90% bill between $37.48 and $241.67.
Top 1% bill above $414.71.
About This Procedure
HCPCS code 12031 was billed by 20 providers across 1K claims, totaling $221K in Medicaid payments from 2018–2024. This code was used for 1K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$141.97
Providers Billing
17
National Spending
$221K
Avg/Median Ratio
1.02×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for 12031
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1003082090 | $71K |
| 2 | 1134349954 | $54K |
| 3 | 1396741351 | $43K |
| 4 | 1881023927 | $28K |
| 5 | Dayton Children's Hospital Dayton, OH · General Acute Care Hospital, Children | $5K |
| 6 | 1720089279 | $3K |
| 7 | 1043615263 | $3K |
| 8 | The Cleveland Clinic Foundation Cleveland, OH · General Acute Care Hospital | $2K |
| 9 | 1861930984 | $2K |
| 10 | 1093103087 | $2K |
| 11 | 1619099124 | $2K |
| 12 | Henry Ford Health System Detroit, MI · General Acute Care Hospital | $2K |
| 13 | 1265758262 | $1K |
| 14 | 1235671389 | $832 |
| 15 | 1508815556 | $802 |
| 16 | 1811080526 | $486 |
| 17 | The Metrohealth System Cleveland, OH · General Acute Care Hospital | $175 |
| 18 | 300048396 | $0 |
| 19 | 1427229384 | $0 |
| 20 | 300048395 | $0 |
Showing top 20 of 20 providers billing this code