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#604 of 11K

D1354

HCPCS Procedure Code

HCPCS code D1354 is the #604 most-billed Medicaid procedure code, with $128.8M in payments across 6.6M claims from 2018–2024. The national median cost per claim is $12.52. Costs vary widely — the 90th percentile is $37.18 per claim, 3.0× the median.

Total Paid

$128.8M

0.01% of all spending

Total Claims

6.6M

Providers

3K

Avg Cost/Claim

$20

National Cost Distribution

How much do providers bill per claim for D1354? Based on 3K providers billing this code nationally.

Median

$12.52

Average

$18.63

Std Dev

$22.27

Max

$719.00

Percentile Distribution (Cost per Claim)

p10
$3.15
p25
$6.41
Median
$12.52
p75
$25.00
p90
$37.18
p95
$57.52
p99
$85.16

50% of providers bill between $6.41 and $25.00 per claim for this code.

90% bill between $3.15 and $37.18.

Top 1% bill above $85.16.

About This Procedure

HCPCS code D1354 was billed by 3K providers across 6.6M claims, totaling $128.8M in Medicaid payments from 2018–2024. This code was used for 1.8M unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$12.52

Providers Billing

3K

National Spending

$128.8M

Avg/Median Ratio

1.49×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for D1354

#ProviderTotal Paid
1Jessica Marn Dds Dental Outreach Pllc

Toledo, OH · Dentist

$10.9M
21831328004$5.3M
31194963181$2.6M
41841607231$2.3M
51508448572$2.1M
61942614417$2.1M
71205089109$2.1M
81881769602$1.9M
91356509731$1.6M
101225201460$1.6M
111891854360$1.5M
121417447673$1.5M
131053885376$1.5M
14My Community Dental Centers Inc

Petoskey, MI · Dentist, Dental Public Health

$1.4M
151184719262$1.4M
161124689617$1.2M
171851536817$1.1M
181811932288$1.0M
191093115065$1.0M
201831367192$977K

Showing top 20 of 3K providers billing this code