#1978 of 11K

36471

HCPCS Procedure Code

HCPCS code 36471 is the #1,978 most-billed Medicaid procedure code, with $10.6M in payments across 105K claims from 2018–2024. The national median cost per claim is $105.39.

Total Paid

$10.6M

0.00% of all spending

Total Claims

105K

Providers

127

Avg Cost/Claim

$101

National Cost Distribution

How much do providers bill per claim for 36471? Based on 125 providers billing this code nationally.

Median

$105.39

Average

$109.38

Std Dev

$77.47

Max

$692.53

Percentile Distribution (Cost per Claim)

p10

$36.16

p25

$55.74

Median

$105.39

p75

$145.86

p90

$177.07

p95

$196.09

p99

$321.22

50% of providers bill between $55.74 and $145.86 per claim for this code.

90% bill between $36.16 and $177.07.

Top 1% bill above $321.22.

About This Procedure

HCPCS code 36471 was billed by 127 providers across 105K claims, totaling $10.6M in Medicaid payments from 2018–2024. This code was used for 72K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$105.39

Providers Billing

125

National Spending

$10.6M

Avg/Median Ratio

1.04×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 36471

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1821415142	$771K	$157.53	1.5× median	Above 75th
2	1255459210	$724K	$139.21	1.3× median	Above Median
3	1154356087	$670K	$145.86	1.4× median	Above 75th
4	1922265982	$545K	$169.15	1.6× median	Above 75th
5	1457685398	$542K	$105.39	1.0× median	Above Median
6	1164773560	$424K	$142.20	1.3× median	Above Median
7	1649500141	$392K	$160.08	1.5× median	Above 75th
8	1073929121	$374K	$78.18	0.7× median	Below Median
9	1295053502	$355K	$45.12	0.4× median	Below Median
10	1700331196	$333K	$180.19	1.7× median	Top 10%
11	1013954999	$332K	$72.83	0.7× median	Below Median
12	1720388267	$306K	$105.78	1.0× median	Above Median
13	1205897592	$304K	$80.82	0.8× median	Below Median
14	1962828277	$275K	$152.39	1.4× median	Above 75th
15	1336163336	$226K	$216.74	2.1× median	Top 10%
16	1326392168	$213K	$137.82	1.3× median	Above Median
17	1902122161	$207K	$157.53	1.5× median	Above 75th
18	1710312699	$193K	$56.08	0.5× median	Below Median
19	Advanced Minimally Invasive Surgical Phoenix, AZ · Surgery	$189K	$139.21	1.3× median	Above Median
20	1194918789	$159K	$126.29	1.2× median	Above Median

Showing top 20 of 127 providers billing this code

Related Procedures

36475$122.4M 36465$95.8M 36478$93.9M 36466$14.1M 36473$1.6M

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