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#5635 of 11K

00103

HCPCS Procedure Code

HCPCS code 00103 is the #5,635 most-billed Medicaid procedure code, with $164K in payments across 3K claims from 2018–2024. The national median cost per claim is $78.28. Costs vary widely — the 90th percentile is $163.44 per claim, 2.1× the median.

Total Paid

$164K

0.00% of all spending

Total Claims

3K

Providers

23

Avg Cost/Claim

$56

National Cost Distribution

How much do providers bill per claim for 00103? Based on 22 providers billing this code nationally.

Median

$78.28

Average

$92.36

Std Dev

$61.45

Max

$253.78

Percentile Distribution (Cost per Claim)

p10
$35.85
p25
$42.90
Median
$78.28
p75
$130.79
p90
$163.44
p95
$191.53
p99
$241.01

50% of providers bill between $42.90 and $130.79 per claim for this code.

90% bill between $35.85 and $163.44.

Top 1% bill above $241.01.

About This Procedure

HCPCS code 00103 was billed by 23 providers across 3K claims, totaling $164K in Medicaid payments from 2018–2024. This code was used for 3K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$78.28

Providers Billing

22

National Spending

$164K

Avg/Median Ratio

1.18×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 00103

#ProviderTotal Paid
11760646558$48K
21922297761$34K
31972126209$14K
41053354233$11K
51710962865$10K
61003479403$8K
71063710689$7K
81356444897$5K
91487609475$5K
101124192943$4K
111649306218$4K
121437326857$3K
131346267267$2K
141073658027$2K
151154815264$1K
161134381007$1K
171093767766$1K
181427093863$982
191245338573$969
201992726855$910

Showing top 20 of 23 providers billing this code