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#1583 of 11K

00813

HCPCS Procedure Code

HCPCS code 00813 is the #1,583 most-billed Medicaid procedure code, with $18.5M in payments across 271K claims from 2018–2024. The national median cost per claim is $71.82. Costs vary widely — the 90th percentile is $151.56 per claim, 2.1× the median.

Total Paid

$18.5M

0.00% of all spending

Total Claims

271K

Providers

758

Avg Cost/Claim

$68

National Cost Distribution

How much do providers bill per claim for 00813? Based on 703 providers billing this code nationally.

Median

$71.82

Average

$83.61

Std Dev

$61.07

Max

$503.77

Percentile Distribution (Cost per Claim)

p10
$23.08
p25
$41.21
Median
$71.82
p75
$111.19
p90
$151.56
p95
$187.07
p99
$306.18

50% of providers bill between $41.21 and $111.19 per claim for this code.

90% bill between $23.08 and $151.56.

Top 1% bill above $306.18.

About This Procedure

HCPCS code 00813 was billed by 758 providers across 271K claims, totaling $18.5M in Medicaid payments from 2018–2024. This code was used for 227K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$71.82

Providers Billing

703

National Spending

$18.5M

Avg/Median Ratio

1.16×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 00813

#ProviderTotal Paid
11447207147$491K
21508947441$469K
31952392946$457K
41871986372$427K
51609804541$414K
61821127002$371K
71417994872$351K
81972126209$346K
9Ashland Hospital Corporation

Ashland, KY · Clinic/Center, Rural Health

$339K
101356822902$313K
111649264706$309K
121144334228$275K
13Owensboro Health Inc

Owensboro, KY · General Acute Care Hospital

$249K
141023124625$239K
151801063755$236K
161861662991$234K
171558391763$227K
181821448150$223K
191720386402$216K
201487677951$211K

Showing top 20 of 758 providers billing this code