Statistical flags indicate unusual patterns — not proof of fraud or wrongdoing. Read our methodology

#4817 of 11K

Z1038

HCPCS Procedure Code

HCPCS code Z1038 is the #4,817 most-billed Medicaid procedure code, with $387K in payments across 50K claims from 2018–2024. The national median cost per claim is $54.47.

Total Paid

$387K

0.00% of all spending

Total Claims

50K

Providers

252

Avg Cost/Claim

$8

National Cost Distribution

How much do providers bill per claim for Z1038? Based on 62 providers billing this code nationally.

Median

$54.47

Average

$51.62

Std Dev

$8.44

Max

$55.34

Percentile Distribution (Cost per Claim)

p10
$43.97
p25
$54.43
Median
$54.47
p75
$54.70
p90
$54.85
p95
$54.88
p99
$55.09

50% of providers bill between $54.43 and $54.70 per claim for this code.

90% bill between $43.97 and $54.85.

Top 1% bill above $55.09.

About This Procedure

HCPCS code Z1038 was billed by 252 providers across 50K claims, totaling $387K in Medicaid payments from 2018–2024. This code was used for 48K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$54.47

Providers Billing

62

National Spending

$387K

Avg/Median Ratio

0.95×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for Z1038

#ProviderTotal Paid
11730136680$69K
21760545503$54K
31912176264$29K
41164061461$26K
51265668784$23K
61487095337$18K
71669776175$15K
81609913441$14K
91255587630$12K
101396721197$12K
111114301298$11K
121073578134$8K
131255849238$8K
141629107636$7K
151669548483$7K
161033256573$7K
171508046251$6K
181710921440$4K
191356498935$4K
201407941586$4K

Showing top 20 of 252 providers billing this code