0160
HCPCS Procedure Code
HCPCS code 0160 is the #767 most-billed Medicaid procedure code, with $85.3M in payments across 248K claims from 2018–2024. The national median cost per claim is $54.01. Costs vary widely — the 90th percentile is $1,992.30 per claim, 36.9× the median.
Total Paid
$85.3M
0.01% of all spending
Total Claims
248K
Providers
153
Avg Cost/Claim
$344
National Cost Distribution
How much do providers bill per claim for 0160? Based on 145 providers billing this code nationally.
Median
$54.01
Average
$858.55
Std Dev
$2,391.52
Max
$15,242.34
Percentile Distribution (Cost per Claim)
50% of providers bill between $27.50 and $312.71 per claim for this code.
90% bill between $7.95 and $1,992.30.
Top 1% bill above $12,958.07.
About This Procedure
HCPCS code 0160 was billed by 153 providers across 248K claims, totaling $85.3M in Medicaid payments from 2018–2024. This code was used for 162K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$54.01
Providers Billing
145
National Spending
$85.3M
Avg/Median Ratio
15.90×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for 0160
| # | Provider | Total Paid |
|---|---|---|
| 1 | Del Dios Care Llc Escondido, CA · Assisted Living Facility | $11.2M |
| 2 | Affordable Senior Housing Foundation Escondido, CA · Assisted Living Facility | $9.4M |
| 3 | 1134101348 | $8.1M |
| 4 | Del Rio Care Llc San Diego, CA · Assisted Living Facility | $7.7M |
| 5 | 1487681631 | $5.3M |
| 6 | 1104229012 | $4.5M |
| 7 | 1811552086 | $4.5M |
| 8 | County Of San Diego San Diego, CA · Public Health or Welfare | $4.3M |
| 9 | 1336289966 | $4.3M |
| 10 | County Of Ventura Ventura, CA · Clinic/Center, Emergency Care | $3.5M |
| 11 | 1700973963 | $2.8M |
| 12 | 1114112620 | $2.2M |
| 13 | Grossmont Hospital Corporation La Mesa, CA · General Acute Care Hospital | $1.8M |
| 14 | 1477705416 | $1.3M |
| 15 | 1588799670 | $1.3M |
| 16 | 1154572782 | $1.2M |
| 17 | 1699129601 | $876K |
| 18 | 1588663769 | $850K |
| 19 | 1811946734 | $770K |
| 20 | 1114367497 | $577K |
Showing top 20 of 153 providers billing this code