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#5838 of 11K

31238

HCPCS Procedure Code

HCPCS code 31238 is the #5,838 most-billed Medicaid procedure code, with $130K in payments across 720 claims from 2018–2024. The national median cost per claim is $233.98. Costs vary widely — the 90th percentile is $531.43 per claim, 2.3× the median.

Total Paid

$130K

0.00% of all spending

Total Claims

720

Providers

17

Avg Cost/Claim

$181

National Cost Distribution

How much do providers bill per claim for 31238? Based on 17 providers billing this code nationally.

Median

$233.98

Average

$283.78

Std Dev

$200.43

Max

$812.55

Percentile Distribution (Cost per Claim)

p10
$122.90
p25
$169.88
Median
$233.98
p75
$292.80
p90
$531.43
p95
$720.51
p99
$794.14

50% of providers bill between $169.88 and $292.80 per claim for this code.

90% bill between $122.90 and $531.43.

Top 1% bill above $794.14.

About This Procedure

HCPCS code 31238 was billed by 17 providers across 720 claims, totaling $130K in Medicaid payments from 2018–2024. This code was used for 573 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$233.98

Providers Billing

17

National Spending

$130K

Avg/Median Ratio

1.21×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 31238

#ProviderTotal Paid
11841484235$26K
21265764484$17K
31861629073$12K
41689664906$11K
51003865908$11K
61225323389$8K
71013309459$8K
81124026422$8K
91083713101$4K
101063643641$4K
111508978271$4K
121922273119$3K
131619967254$3K
141124079769$3K
151912039710$2K
161558475087$2K
171235198250$1K

Showing top 17 of 17 providers billing this code