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#1271 of 11K

0072A

HCPCS Procedure Code

HCPCS code 0072A is the #1,271 most-billed Medicaid procedure code, with $29.8M in payments across 668K claims from 2018–2024. The national median cost per claim is $39.57.

Total Paid

$29.8M

0.00% of all spending

Total Claims

668K

Providers

5K

Avg Cost/Claim

$45

National Cost Distribution

How much do providers bill per claim for 0072A? Based on 5K providers billing this code nationally.

Median

$39.57

Average

$44.12

Std Dev

$50.83

Max

$873.31

Percentile Distribution (Cost per Claim)

p10
$24.16
p25
$35.16
Median
$39.57
p75
$42.09
p90
$54.36
p95
$67.00
p99
$177.30

50% of providers bill between $35.16 and $42.09 per claim for this code.

90% bill between $24.16 and $54.36.

Top 1% bill above $177.30.

About This Procedure

HCPCS code 0072A was billed by 5K providers across 668K claims, totaling $29.8M in Medicaid payments from 2018–2024. This code was used for 625K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$39.57

Providers Billing

5K

National Spending

$29.8M

Avg/Median Ratio

1.11×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 0072A

#ProviderTotal Paid
1Dhhs Phs Naihs Shiprock Hospital

Shiprock, NM · General Acute Care Hospital

$643K
2Pine Ridge Indian Health Service Hospital

Pine Ridge, SD · General Acute Care Hospital

$574K
3Dhhs,phs,naihs, Gallup Indian Medical Center

Gallup, NM · General Acute Care Hospital

$472K
4Permanente Medical Group Inc

Stockton, CA · Anesthesiology

$351K
5County Of Santa Clara

San Jose, CA · Case Manager/Care Coordinator

$338K
6Zuni Indian Hospital

Zuni, NM · General Acute Care Hospital

$317K
7Rosebud Indian Health Service

Rosebud, SD · General Acute Care Hospital

$295K
8Phs Indian Hospital

Red Lake, MN · General Acute Care Hospital

$293K
9Arkansas Childrens Hospital

Little Rock, AR · Clinic/Center, Critical Access Hospital

$238K
10Dhhs Phs Naihs Crownpoint Hospital

Crownpoint, NM · General Acute Care Hospital

$192K
11Topcare Medical Group Inc

Dallas, TX · Pediatrics

$180K
12Tanana Chiefs Conference

Fairbanks, AK · Clinic/Center Multi-Specialty

$176K
13Permanente Medical Group Inc

Richmond, CA · Internal Medicine

$165K
14Pine Ridge Indian Health Service Hospital

Kyle, SD · Clinic/Center

$154K
15Santa Fe Indian Hospital

Santa Fe, NM · General Acute Care Hospital

$153K
16Federico Herrera

Chicago, IL · Pediatrics

$132K
17State Of Indiana Auditor Of State

Indianapolis, IN · Public Health or Welfare

$131K
18The Arizona Partnership For Immunization

Phoenix, AZ · Local Education Agency (LEA)

$130K
19The Griffin Hospital

Derby, CT · Clinic/Center, Emergency Care

$128K
20New York City Health And Hospitals Corporation

Bronx, NY · Internal Medicine

$124K

Showing top 20 of 5K providers billing this code