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#1273 of 11K

0123

HCPCS Procedure Code

HCPCS code 0123 is the #1,273 most-billed Medicaid procedure code, with $29.7M in payments across 9K claims from 2018–2024. The national median cost per claim is $3,178.88. Costs vary widely — the 90th percentile is $7,854.57 per claim, 2.5× the median.

Total Paid

$29.7M

0.00% of all spending

Total Claims

9K

Providers

16

Avg Cost/Claim

$3K

National Cost Distribution

How much do providers bill per claim for 0123? Based on 12 providers billing this code nationally.

Median

$3,178.88

Average

$4,205.59

Std Dev

$3,035.46

Max

$8,350.96

Percentile Distribution (Cost per Claim)

p10
$1,140.33
p25
$1,908.30
Median
$3,178.88
p75
$7,155.18
p90
$7,854.57
p95
$8,081.14
p99
$8,297.00

50% of providers bill between $1,908.30 and $7,155.18 per claim for this code.

90% bill between $1,140.33 and $7,854.57.

Top 1% bill above $8,297.00.

About This Procedure

HCPCS code 0123 was billed by 16 providers across 9K claims, totaling $29.7M in Medicaid payments from 2018–2024. This code was used for 9K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$3,178.88

Providers Billing

12

National Spending

$29.7M

Avg/Median Ratio

1.32×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 0123

#ProviderTotal Paid
1Childrens Hospital Of Los Angeles

Los Angeles, CA · Case Manager/Care Coordinator

$21.9M
21710065933$1.9M
3Children's Hospital & Research Center At Oakland

Oakland, CA · General Acute Care Hospital

$1.7M
4County Of Santa Clara

San Jose, CA · Case Manager/Care Coordinator

$1.5M
51750384079$1.0M
61003102781$502K
71811080526$402K
81740215219$359K
91215927470$253K
101811129752$101K
111821250762$29K
121578529285$14K
131275975104$0
141265530653$0
151750503017$0
161669617197$0

Showing top 16 of 16 providers billing this code