0154A
HCPCS Procedure Code
HCPCS code 0154A is the #3,209 most-billed Medicaid procedure code, with $2.2M in payments across 49K claims from 2018–2024. The national median cost per claim is $39.23.
Total Paid
$2.2M
0.00% of all spending
Total Claims
49K
Providers
515
Avg Cost/Claim
$46
National Cost Distribution
How much do providers bill per claim for 0154A? Based on 495 providers billing this code nationally.
Median
$39.23
Average
$47.50
Std Dev
$74.56
Max
$647.72
Percentile Distribution (Cost per Claim)
50% of providers bill between $34.08 and $41.80 per claim for this code.
90% bill between $22.90 and $56.72.
Top 1% bill above $629.70.
About This Procedure
HCPCS code 0154A was billed by 515 providers across 49K claims, totaling $2.2M in Medicaid payments from 2018–2024. This code was used for 45K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$39.23
Providers Billing
495
National Spending
$2.2M
Avg/Median Ratio
1.21×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for 0154A
| # | Provider | Total Paid |
|---|---|---|
| 1 | Rosebud Indian Health Service Rosebud, SD · General Acute Care Hospital | $183K |
| 2 | Dhhs Phs Naihs Shiprock Hospital Shiprock, NM · General Acute Care Hospital | $124K |
| 3 | Zuni Indian Hospital Zuni, NM · General Acute Care Hospital | $77K |
| 4 | Dhhs,phs,naihs, Gallup Indian Medical Center Gallup, NM · General Acute Care Hospital | $63K |
| 5 | Children's Hospital Medical Center Of Akron Akron, OH · General Acute Care Hospital Children | $62K |
| 6 | Permanente Medical Group Inc Stockton, CA · Anesthesiology | $52K |
| 7 | Permanente Medical Group Inc Richmond, CA · Internal Medicine | $41K |
| 8 | 1952386153 | $33K |
| 9 | Richard Bone Chicago, IL · Internal Medicine, Gastroenterology | $33K |
| 10 | 1750443503 | $30K |
| 11 | Arkansas Childrens Hospital Little Rock, AR · Clinic/Center, Critical Access Hospital | $27K |
| 12 | Children's Hospital Medical Center Cincinnati, OH · Clinic/Center, Primary Care | $27K |
| 13 | The Nemours Foundation Wilmington, DE · Clinic/Center, Developmental Disabilities | $25K |
| 14 | Acoma-canoncito-laguna Indian Health Center Acoma, NM · Clinic/Center, Health Services | $24K |
| 15 | County Of Santa Clara San Jose, CA · Case Manager/Care Coordinator | $22K |
| 16 | The General Hospital Corporation Boston, MA · General Acute Care Hospital | $20K |
| 17 | Boston Medical Center Corporation Boston, MA · General Acute Care Hospital | $20K |
| 18 | Presbyterian Healthcare Services Albuquerque, NM · Surgery | $20K |
| 19 | Alamo Navajo School Board, Inc. Alamo, NM · Clinic/Center, Primary Care | $19K |
| 20 | Southern California Permanente Medical Group Baldwin Park, CA · Health Maintenance Organization | $19K |
Showing top 20 of 515 providers billing this code