#2284 of 11K

L0631

HCPCS Procedure Code

HCPCS code L0631 is the #2,284 most-billed Medicaid procedure code, with $7.1M in payments across 15K claims from 2018–2024. The national median cost per claim is $412.00.

Total Paid

$7.1M

0.00% of all spending

Total Claims

15K

Providers

Avg Cost/Claim

$487

National Cost Distribution

How much do providers bill per claim for L0631? Based on 50 providers billing this code nationally.

Median

$412.00

Average

$437.62

Std Dev

$272.25

Max

$1,164.97

Percentile Distribution (Cost per Claim)

p10

$95.00

p25

$230.81

Median

$412.00

p75

$661.58

p90

$734.00

p95

$819.29

p99

$1,013.05

50% of providers bill between $230.81 and $661.58 per claim for this code.

90% bill between $95.00 and $734.00.

Top 1% bill above $1,013.05.

About This Procedure

HCPCS code L0631 was billed by 52 providers across 15K claims, totaling $7.1M in Medicaid payments from 2018–2024. This code was used for 14K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$412.00

Providers Billing

National Spending

$7.1M

Avg/Median Ratio

1.06×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for L0631

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1710420740	$1.7M	$697.13	1.7× median	Above 75th
2	1407307614	$1.3M	$731.86	1.8× median	Above 75th
3	Integra Partners Llc Troy, MI · Orthotic Fitter	$616K	$544.78	1.3× median	Above Median
4	1730364530	$444K	$627.03	1.5× median	Above Median
5	1295862019	$336K	$274.73	0.7× median	Below Median
6	1508297854	$318K	$130.00	0.3× median	Below Median
7	1992785315	$295K	$724.52	1.8× median	Above 75th
8	1093819419	$289K	$1,164.97	2.8× median	Top 1%
9	1871503235	$233K	$663.86	1.6× median	Above 75th
10	1770096372	$232K	$406.52	1.0× median	Below Median
11	1134182207	$174K	$732.41	1.8× median	Above 75th
12	1922440684	$173K	$854.94	2.1× median	Top 10%
13	1902815665	$147K	$598.35	1.5× median	Above Median
14	1942423579	$127K	$403.90	1.0× median	Below Median
15	1790947828	$121K	$645.31	1.6× median	Above Median
16	1407106339	$110K	$501.03	1.2× median	Above Median
17	1437196557	$62K	$291.29	0.7× median	Below Median
18	1689750564	$60K	$293.33	0.7× median	Below Median
19	1144527003	$48K	$257.47	0.6× median	Below Median
20	1184766107	$42K	$261.60	0.6× median	Below Median

Showing top 20 of 52 providers billing this code

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