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#5097 of 11K

00402

HCPCS Procedure Code

HCPCS code 00402 is the #5,097 most-billed Medicaid procedure code, with $292K in payments across 3K claims from 2018–2024. The national median cost per claim is $128.23. Costs vary widely — the 90th percentile is $452.62 per claim, 3.5× the median.

Total Paid

$292K

0.00% of all spending

Total Claims

3K

Providers

26

Avg Cost/Claim

$94

National Cost Distribution

How much do providers bill per claim for 00402? Based on 19 providers billing this code nationally.

Median

$128.23

Average

$183.81

Std Dev

$142.96

Max

$486.18

Percentile Distribution (Cost per Claim)

p10
$69.35
p25
$93.33
Median
$128.23
p75
$233.98
p90
$452.62
p95
$466.04
p99
$482.15

50% of providers bill between $93.33 and $233.98 per claim for this code.

90% bill between $69.35 and $452.62.

Top 1% bill above $482.15.

About This Procedure

HCPCS code 00402 was billed by 26 providers across 3K claims, totaling $292K in Medicaid payments from 2018–2024. This code was used for 2K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$128.23

Providers Billing

19

National Spending

$292K

Avg/Median Ratio

1.43×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 00402

#ProviderTotal Paid
11972126209$52K
21508947441$50K
31740232321$46K
41487609475$20K
51093767766$20K
61861448235$16K
71053366377$16K
81053358937$13K
91528010428$10K
101053782466$10K
111417994872$9K
12Ahs Hospital Corp.

Summit, NJ · General Acute Care Hospital

$7K
13Montefiore Medical Center

Bronx, NY · Anesthesiology

$5K
141558314427$5K
151710324041$5K
161497797153$3K
171669581997$2K
181871986372$2K
191912943184$781
201235196510$0

Showing top 20 of 26 providers billing this code