#4188 of 11K

00630

HCPCS Procedure Code

HCPCS code 00630 is the #4,188 most-billed Medicaid procedure code, with $771K in payments across 9K claims from 2018–2024. The national median cost per claim is $86.96. Costs vary widely — the 90th percentile is $205.37 per claim, 2.4× the median.

Total Paid

$771K

0.00% of all spending

Total Claims

Providers

Avg Cost/Claim

$89

National Cost Distribution

How much do providers bill per claim for 00630? Based on 37 providers billing this code nationally.

Median

$86.96

Average

$100.97

Std Dev

$70.48

Max

$386.59

Percentile Distribution (Cost per Claim)

p10

$40.92

p25

$55.31

Median

$86.96

p75

$114.47

p90

$205.37

p95

$215.58

p99

$325.05

50% of providers bill between $55.31 and $114.47 per claim for this code.

90% bill between $40.92 and $205.37.

Top 1% bill above $325.05.

About This Procedure

HCPCS code 00630 was billed by 38 providers across 9K claims, totaling $771K in Medicaid payments from 2018–2024. This code was used for 7K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$86.96

Providers Billing

National Spending

$771K

Avg/Median Ratio

1.16×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 00630

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1538404256	$85K	$95.56	1.1× median	Above Median
2	1376596650	$79K	$113.29	1.3× median	Above Median
3	1972126209	$75K	$92.51	1.1× median	Above Median
4	1740264332	$64K	$215.56	2.5× median	Top 10%
5	1487716304	$51K	$127.75	1.5× median	Above 75th
6	1750594941	$50K	$47.24	0.5× median	Below Median
7	1558314427	$36K	$215.65	2.5× median	Top 10%
8	1487609475	$34K	$78.71	0.9× median	Below Median
9	1669581997	$31K	$81.66	0.9× median	Below Median
10	1255494803	$29K	$103.19	1.2× median	Above Median
11	1457634768	$26K	$116.44	1.3× median	Above 75th
12	1396783270	$24K	$55.31	0.6× median	Below Median
13	1558391763	$20K	$386.59	4.4× median	Top 1%
14	1225016926	$18K	$99.80	1.1× median	Above Median
15	1730511833	$17K	$49.13	0.6× median	Below Median
16	1306355573	$17K	$114.47	1.3× median	Above 75th
17	1477766574	$13K	$41.11	0.5× median	Below Median
18	1497797153	$12K	$90.07	1.0× median	Above Median
19	1740403658	$11K	$150.46	1.7× median	Above 75th
20	1659883486	$10K	$209.69	2.4× median	Top 10%

Showing top 20 of 38 providers billing this code

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