#2731 of 11K

0013A

HCPCS Procedure Code

HCPCS code 0013A is the #2,731 most-billed Medicaid procedure code, with $3.9M in payments across 137K claims from 2018–2024. The national median cost per claim is $35.38.

Total Paid

$3.9M

0.00% of all spending

Total Claims

137K

Providers

Avg Cost/Claim

$29

National Cost Distribution

How much do providers bill per claim for 0013A? Based on 1K providers billing this code nationally.

Median

$35.38

Average

$36.41

Std Dev

$43.84

Max

$526.96

Percentile Distribution (Cost per Claim)

p10

$5.71

p25

$19.68

Median

$35.38

p75

$40.00

p90

$47.59

p95

$66.79

p99

$178.40

50% of providers bill between $19.68 and $40.00 per claim for this code.

90% bill between $5.71 and $47.59.

Top 1% bill above $178.40.

About This Procedure

HCPCS code 0013A was billed by 2K providers across 137K claims, totaling $3.9M in Medicaid payments from 2018–2024. This code was used for 128K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$35.38

Providers Billing

National Spending

$3.9M

Avg/Median Ratio

1.03×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 0013A

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	Cdva Corp Villalba, PR · Health Maintenance Organization	$134K	$39.49	1.1× median	Above Median
2	The Fort Defiance Indian Hospital Board, Incorporation Fort Defiance, AZ · General Acute Care Hospital	$116K	$488.83	13.8× median	Top 1%
3	1750510277	$74K	$526.96	14.9× median	Top 1%
4	1326053166	$70K	$505.42	14.3× median	Top 1%
5	Dhhs Phs Naihs Crownpoint Hospital Crownpoint, NM · General Acute Care Hospital	$52K	$499.04	14.1× median	Top 1%
6	1487925665	$45K	$24.40	0.7× median	Below Median
7	1104216050	$44K	$38.95	1.1× median	Above Median
8	1245289214	$38K	$41.77	1.2× median	Above 75th
9	1669485975	$36K	$165.11	4.7× median	Top 10%
10	1992732192	$35K	$40.00	1.1× median	Above 75th
11	Boston Medical Center Corporation Boston, MA · General Acute Care Hospital	$31K	$19.46	0.5× median	Below Median
12	County Of Los Angeles Los Angeles, CA · Clinic/Center, Public Health, State or Local	$30K	$40.00	1.1× median	Above 75th
13	1548425911	$30K	$173.27	4.9× median	Top 10%
14	Federico Herrera Chicago, IL · Pediatrics	$27K	$41.97	1.2× median	Above 75th
15	1114224649	$27K	$35.71	1.0× median	Above Median
16	1265732184	$26K	$37.33	1.1× median	Above Median
17	1790776334	$26K	$26.09	0.7× median	Below Median
18	1982747671	$26K	$62.50	1.8× median	Top 10%
19	1972528032	$25K	$39.08	1.1× median	Above Median
20	1831250398	$23K	$456.72	12.9× median	Top 1%

Showing top 20 of 2K providers billing this code

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