#1220 of 11K

K0003

HCPCS Procedure Code

HCPCS code K0003 is the #1,220 most-billed Medicaid procedure code, with $32.9M in payments across 1.3M claims from 2018–2024. The national median cost per claim is $18.14. Costs vary widely — the 90th percentile is $47.87 per claim, 2.6× the median.

Total Paid

$32.9M

0.00% of all spending

Total Claims

1.3M

Providers

923

Avg Cost/Claim

$25

National Cost Distribution

How much do providers bill per claim for K0003? Based on 913 providers billing this code nationally.

Median

$18.14

Average

$25.82

Std Dev

$36.20

Max

$761.49

Percentile Distribution (Cost per Claim)

p10

$6.37

p25

$10.32

Median

$18.14

p75

$31.93

p90

$47.87

p95

$61.73

p99

$122.71

50% of providers bill between $10.32 and $31.93 per claim for this code.

90% bill between $6.37 and $47.87.

Top 1% bill above $122.71.

About This Procedure

HCPCS code K0003 was billed by 923 providers across 1.3M claims, totaling $32.9M in Medicaid payments from 2018–2024. This code was used for 1.2M unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$18.14

Providers Billing

913

National Spending

$32.9M

Avg/Median Ratio

1.42×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for K0003

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	Apria Healthcare Llc Indianapolis, IN · Durable Medical Equipment & Medical Supplies	$2.9M	$45.06	2.5× median	Above 75th
2	Med Star Surgical & Breathing Equipment Inc. Bronx, NY · Prosthetic/Orthotic Supplier	$1.3M	$18.00	1.0× median	Below Median
3	H & H Drug Stores, Inc Glendale, CA · Durable Medical Equipment & Medical Supplies	$846K	$30.47	1.7× median	Above Median
4	1326077249	$721K	$38.43	2.1× median	Above 75th
5	Home Medical Equipment Specialists Llc Albuquerque, NM · Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies	$646K	$39.92	2.2× median	Above 75th
6	1386688414	$577K	$24.73	1.4× median	Above Median
7	1730182023	$566K	$14.68	0.8× median	Below Median
8	Super Care Inc City Of Industry, CA · Durable Medical Equipment & Medical Supplies	$450K	$34.64	1.9× median	Above 75th
9	1922046085	$376K	$49.09	2.7× median	Top 10%
10	Binson's Hospital Supplies, Inc. Center Line, MI · Durable Medical Equipment & Medical Supplies, Customized Equipment	$368K	$41.11	2.3× median	Above 75th
11	1720196983	$352K	$26.34	1.5× median	Above Median
12	1003834946	$346K	$36.42	2.0× median	Above 75th
13	1255382123	$346K	$23.79	1.3× median	Above Median
14	1174749972	$342K	$31.93	1.8× median	Above Median
15	Integra Partners Llc Troy, MI · Orthotic Fitter	$335K	$39.51	2.2× median	Above 75th
16	1265526396	$333K	$63.86	3.5× median	Top 10%
17	1821418187	$329K	$18.69	1.0× median	Above Median
18	1184716672	$311K	$42.03	2.3× median	Above 75th
19	1003924713	$302K	$63.66	3.5× median	Top 10%
20	1407894348	$301K	$36.23	2.0× median	Above 75th

Showing top 20 of 923 providers billing this code

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