#3805 of 11K

31233

HCPCS Procedure Code

HCPCS code 31233 is the #3,805 most-billed Medicaid procedure code, with $1.1M in payments across 7K claims from 2018–2024. The national median cost per claim is $140.15.

Total Paid

$1.1M

0.00% of all spending

Total Claims

Providers

Avg Cost/Claim

$167

National Cost Distribution

How much do providers bill per claim for 31233? Based on 18 providers billing this code nationally.

Median

$140.15

Average

$149.16

Std Dev

$109.29

Max

$409.83

Percentile Distribution (Cost per Claim)

p10

$23.65

p25

$62.61

Median

$140.15

p75

$240.19

p90

$262.58

p95

$289.58

p99

$385.78

50% of providers bill between $62.61 and $240.19 per claim for this code.

90% bill between $23.65 and $262.58.

Top 1% bill above $385.78.

About This Procedure

HCPCS code 31233 was billed by 19 providers across 7K claims, totaling $1.1M in Medicaid payments from 2018–2024. This code was used for 6K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$140.15

Providers Billing

National Spending

$1.1M

Avg/Median Ratio

1.06×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 31233

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1851363055	$638K	$187.06	1.3× median	Above Median
2	1164423828	$215K	$149.38	1.1× median	Above Median
3	1760474092	$137K	$260.11	1.9× median	Above 75th
4	1447480918	$32K	$409.83	2.9× median	Top 1%
5	1063474153	$28K	$268.36	1.9× median	Top 10%
6	1285925719	$24K	$131.34	0.9× median	Below Median
7	1194431817	$23K	$257.90	1.8× median	Above 75th
8	1750565594	$11K	$134.51	1.0× median	Below Median
9	1790775484	$10K	$145.79	1.0× median	Above Median
10	1639285513	$6K	$33.64	0.2× median	Below Median
11	1689664906	$5K	$55.91	0.4× median	Below Median
12	1265764484	$3K	$60.89	0.4× median	Below Median
13	1568534766	$3K	$258.74	1.8× median	Above 75th
14	1871620682	$2K	$67.77	0.5× median	Below Median
15	1114024312	$2K	$157.75	1.1× median	Above Median
16	1649410309	$2K	$105.35	0.8× median	Below Median
17	1194079970	$83	$0.36	0.0× median	Below Median
18	Johns Hopkins All Children's Hospital Inc St Petersburg, FL · General Acute Care Hospital Children	$27	$0.22	0.0× median	Below Median
19	1326022708	$0	$0.00	0.0× median	Below Median

Showing top 19 of 19 providers billing this code

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