00042
HCPCS Procedure Code
HCPCS code 00042 is the #2,518 most-billed Medicaid procedure code, with $5.2M in payments across 2K claims from 2018–2024. The national median cost per claim is $2,780.39.
Total Paid
$5.2M
0.00% of all spending
Total Claims
2K
Providers
6
Avg Cost/Claim
$3K
National Cost Distribution
How much do providers bill per claim for 00042? Based on 6 providers billing this code nationally.
Median
$2,780.39
Average
$2,752.15
Std Dev
$350.77
Max
$3,154.26
Percentile Distribution (Cost per Claim)
50% of providers bill between $2,500.55 and $3,030.35 per claim for this code.
90% bill between $2,355.57 and $3,120.49.
Top 1% bill above $3,150.88.
About This Procedure
HCPCS code 00042 was billed by 6 providers across 2K claims, totaling $5.2M in Medicaid payments from 2018–2024. This code was used for 2K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$2,780.39
Providers Billing
6
National Spending
$5.2M
Avg/Median Ratio
0.99×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for 00042
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1922605310 | $1.7M |
| 2 | 1740887132 | $1.6M |
| 3 | 1750988143 | $840K |
| 4 | 1437621885 | $710K |
| 5 | 1952908345 | $360K |
| 6 | 1891241139 | $35K |
Showing top 6 of 6 providers billing this code