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#4117 of 11K

01630

HCPCS Procedure Code

HCPCS code 01630 is the #4,117 most-billed Medicaid procedure code, with $833K in payments across 11K claims from 2018–2024. The national median cost per claim is $81.30. Costs vary widely — the 90th percentile is $173.15 per claim, 2.1× the median.

Total Paid

$833K

0.00% of all spending

Total Claims

11K

Providers

34

Avg Cost/Claim

$77

National Cost Distribution

How much do providers bill per claim for 01630? Based on 30 providers billing this code nationally.

Median

$81.30

Average

$107.17

Std Dev

$72.23

Max

$336.74

Percentile Distribution (Cost per Claim)

p10
$51.50
p25
$63.79
Median
$81.30
p75
$119.68
p90
$173.15
p95
$273.05
p99
$322.98

50% of providers bill between $63.79 and $119.68 per claim for this code.

90% bill between $51.50 and $173.15.

Top 1% bill above $322.98.

About This Procedure

HCPCS code 01630 was billed by 34 providers across 11K claims, totaling $833K in Medicaid payments from 2018–2024. This code was used for 7,495 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$81.30

Providers Billing

30

National Spending

$833K

Avg/Median Ratio

1.32×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 01630

#ProviderTotal Paid
11972126209$124K
21225016926$90K
31407821796$82K
41871986372$72K
51558391763$71K
61497797153$69K
71487609475$52K
81558314427$38K
91144626714$37K
101417994872$37K
111669581997$30K
121245708403$23K
131922031442$21K
141114378981$14K
15William Beaumont Hospital

Royal Oak, MI · Internal Medicine, Cardiovascular Disease

$12K
161831536531$12K
171174581185$10K
181639110406$6K
191053366377$6K
201053354233$4K

Showing top 20 of 34 providers billing this code

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