0206
HCPCS Procedure Code
HCPCS code 0206 is the #1,035 most-billed Medicaid procedure code, with $46.7M in payments across 17K claims from 2018–2024. The national median cost per claim is $2,282.75. Costs vary widely — the 90th percentile is $8,188.14 per claim, 3.6× the median.
Total Paid
$46.7M
0.00% of all spending
Total Claims
17K
Providers
42
Avg Cost/Claim
$3K
National Cost Distribution
How much do providers bill per claim for 0206? Based on 33 providers billing this code nationally.
Median
$2,282.75
Average
$3,174.73
Std Dev
$3,214.15
Max
$11,578.93
Percentile Distribution (Cost per Claim)
50% of providers bill between $629.27 and $5,757.61 per claim for this code.
90% bill between $202.23 and $8,188.14.
Top 1% bill above $10,772.28.
About This Procedure
HCPCS code 0206 was billed by 42 providers across 17K claims, totaling $46.7M in Medicaid payments from 2018–2024. This code was used for 14K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$2,282.75
Providers Billing
33
National Spending
$46.7M
Avg/Median Ratio
1.39×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for 0206
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1750384079 | $27.3M |
| 2 | 1215927470 | $3.7M |
| 3 | Sharp Chula Vista Medical Center Chula Vista, CA · General Acute Care Hospital | $3.2M |
| 4 | 1336328244 | $3.0M |
| 5 | Grossmont Hospital Corporation La Mesa, CA · General Acute Care Hospital | $1.9M |
| 6 | County Of Santa Clara San Jose, CA · Case Manager/Care Coordinator | $1.2M |
| 7 | 1801821376 | $1.2M |
| 8 | Port City Operating Company Llc Stockton, CA · General Acute Care Hospital | $930K |
| 9 | Palomar Health Escondido, CA · General Acute Care Hospital | $629K |
| 10 | 1023010113 | $479K |
| 11 | Desert Valley Hospital Llc Victorville, CA · General Acute Care Hospital | $460K |
| 12 | 1710109186 | $393K |
| 13 | 1831188275 | $374K |
| 14 | 1104906569 | $327K |
| 15 | 1124173059 | $225K |
| 16 | 1922033547 | $216K |
| 17 | 1487865184 | $208K |
| 18 | Riverside University Health Systems - Medical Center Moreno Valley, CA · General Acute Care Hospital | $163K |
| 19 | Sharp Memorial Hospital San Diego, CA · General Acute Care Hospital, Women | $150K |
| 20 | 1487697215 | $114K |
Showing top 20 of 42 providers billing this code