#996 of 11K

K0738

HCPCS Procedure Code

HCPCS code K0738 is the #996 most-billed Medicaid procedure code, with $49.4M in payments across 2.5M claims from 2018–2024. The national median cost per claim is $17.69.

Total Paid

$49.4M

0.00% of all spending

Total Claims

2.5M

Providers

910

Avg Cost/Claim

$20

National Cost Distribution

How much do providers bill per claim for K0738? Based on 898 providers billing this code nationally.

Median

$17.69

Average

$19.19

Std Dev

$13.50

Max

$169.26

Percentile Distribution (Cost per Claim)

p10

$5.43

p25

$10.08

Median

$17.69

p75

$25.05

p90

$32.44

p95

$39.21

p99

$63.26

50% of providers bill between $10.08 and $25.05 per claim for this code.

90% bill between $5.43 and $32.44.

Top 1% bill above $63.26.

About This Procedure

HCPCS code K0738 was billed by 910 providers across 2.5M claims, totaling $49.4M in Medicaid payments from 2018–2024. This code was used for 2.2M unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$17.69

Providers Billing

898

National Spending

$49.4M

Avg/Median Ratio

1.08×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for K0738

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	Apria Healthcare Llc Indianapolis, IN · Durable Medical Equipment & Medical Supplies	$2.1M	$18.25	1.0× median	Above Median
2	1902098965	$1.9M	$30.12	1.7× median	Above 75th
3	Medcare Equipment Company, Llc Export, PA · Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies	$1.2M	$20.82	1.2× median	Above Median
4	Palmetto Oxygen Llc Cary, NC · Durable Medical Equipment & Medical Supplies Oxygen Equipment & Supplies	$1.0M	$17.12	1.0× median	Below Median
5	1710083027	$955K	$23.30	1.3× median	Above Median
6	1659487379	$952K	$23.29	1.3× median	Above Median
7	1104882638	$788K	$31.51	1.8× median	Above 75th
8	1972554939	$782K	$20.51	1.2× median	Above Median
9	1881603215	$632K	$20.53	1.2× median	Above Median
10	1588674782	$575K	$18.60	1.1× median	Above Median
11	1144239799	$572K	$22.12	1.3× median	Above Median
12	1407342751	$563K	$28.51	1.6× median	Above 75th
13	1861480048	$516K	$28.30	1.6× median	Above 75th
14	1134713597	$457K	$29.74	1.7× median	Above 75th
15	1326077249	$439K	$23.00	1.3× median	Above Median
16	1588994438	$406K	$38.11	2.2× median	Top 10%
17	1316364011	$364K	$33.70	1.9× median	Top 10%
18	1568537009	$340K	$34.32	1.9× median	Top 10%
19	1538668843	$334K	$28.45	1.6× median	Above 75th
20	Super Care Inc City Of Industry, CA · Durable Medical Equipment & Medical Supplies	$330K	$17.26	1.0× median	Below Median

Showing top 20 of 910 providers billing this code

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K0739$61.3M K0733$13K

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