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#6998 of 11K

0038U

HCPCS Procedure Code

HCPCS code 0038U is the #6,998 most-billed Medicaid procedure code, with $33K in payments across 24K claims from 2018–2024. The national median cost per claim is $0.50. Costs vary widely — the 90th percentile is $6.45 per claim, 12.9× the median.

Total Paid

$33K

0.00% of all spending

Total Claims

24K

Providers

11

Avg Cost/Claim

$1

National Cost Distribution

How much do providers bill per claim for 0038U? Based on 8 providers billing this code nationally.

Median

$0.50

Average

$2.50

Std Dev

$4.59

Max

$13.54

Percentile Distribution (Cost per Claim)

p10
$0.19
p25
$0.25
Median
$0.50
p75
$1.91
p90
$6.45
p95
$9.99
p99
$12.83

50% of providers bill between $0.25 and $1.91 per claim for this code.

90% bill between $0.19 and $6.45.

Top 1% bill above $12.83.

About This Procedure

HCPCS code 0038U was billed by 11 providers across 24K claims, totaling $33K in Medicaid payments from 2018–2024. This code was used for 24K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$0.50

Providers Billing

8

National Spending

$33K

Avg/Median Ratio

5.00×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for 0038U

#ProviderTotal Paid
1County Of Santa Clara

San Jose, CA · Case Manager/Care Coordinator

$23K
21952693277$6K
31598086878$2K
4County Of Santa Clara

San Jose, CA · Clinic/Center Federally Qualified Health Center (FQHC)

$1K
5County Of Santa Clara

San Jose, CA · Clinic/Center Federally Qualified Health Center (FQHC)

$274
6County Of Santa Clara

Milpitas, CA · Clinic/Center Federally Qualified Health Center (FQHC)

$191
7County Of Santa Clara

Gilroy, CA · Clinic/Center Federally Qualified Health Center (FQHC)

$109
81689012148$69
91043354020$0
101588082812$0
11County Of Santa Clara

San Jose, CA · Clinic/Center Federally Qualified Health Center (FQHC)

$0

Showing top 11 of 11 providers billing this code