Statistical flags indicate unusual patterns — not proof of fraud or wrongdoing. Read our methodology

#7024 of 11K

16030

HCPCS Procedure Code

HCPCS code 16030 is the #7,024 most-billed Medicaid procedure code, with $31K in payments across 128 claims from 2018–2024. The national median cost per claim is $167.70. Costs vary widely — the 90th percentile is $349.84 per claim, 2.1× the median.

Total Paid

$31K

0.00% of all spending

Total Claims

128

Providers

3

Avg Cost/Claim

$242

National Cost Distribution

How much do providers bill per claim for 16030? Based on 3 providers billing this code nationally.

Median

$167.70

Average

$221.86

Std Dev

$153.76

Max

$395.37

Percentile Distribution (Cost per Claim)

p10
$115.55
p25
$135.11
Median
$167.70
p75
$281.54
p90
$349.84
p95
$372.61
p99
$390.82

50% of providers bill between $135.11 and $281.54 per claim for this code.

90% bill between $115.55 and $349.84.

Top 1% bill above $390.82.

About This Procedure

HCPCS code 16030 was billed by 3 providers across 128 claims, totaling $31K in Medicaid payments from 2018–2024. This code was used for 90 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$167.70

Providers Billing

3

National Spending

$31K

Avg/Median Ratio

1.32×

Normal distribution

Provider Coverage

We have 3 providers billing this code in our dataset. Individual provider breakdowns are available for top-spending procedure codes.

Related Procedures