0225U
HCPCS Procedure Code
HCPCS code 0225U is the #932 most-billed Medicaid procedure code, with $57.1M in payments across 282K claims from 2018–2024. The national median cost per claim is $81.81. Costs vary widely — the 90th percentile is $381.49 per claim, 4.7× the median.
Total Paid
$57.1M
0.01% of all spending
Total Claims
282K
Providers
88
Avg Cost/Claim
$203
National Cost Distribution
How much do providers bill per claim for 0225U? Based on 80 providers billing this code nationally.
Median
$81.81
Average
$150.08
Std Dev
$155.47
Max
$633.29
Percentile Distribution (Cost per Claim)
50% of providers bill between $17.46 and $316.90 per claim for this code.
90% bill between $5.39 and $381.49.
Top 1% bill above $467.11.
About This Procedure
HCPCS code 0225U was billed by 88 providers across 282K claims, totaling $57.1M in Medicaid payments from 2018–2024. This code was used for 253K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$81.81
Providers Billing
80
National Spending
$57.1M
Avg/Median Ratio
1.83×
Moderately skewed
Top Providers Billing This Code
Ranked by total Medicaid payments for 0225U
| # | Provider | Total Paid |
|---|---|---|
| 1 | Physicians Group Laboratories, Llc Houma, LA · Clinical Medical Laboratory | $42.4M |
| 2 | 1972863611 | $2.3M |
| 3 | 1043218944 | $1.5M |
| 4 | 1477541183 | $1.4M |
| 5 | 1811922347 | $1.2M |
| 6 | 1699757393 | $1.0M |
| 7 | Children's Hospital Washington, DC · General Acute Care Hospital Children | $964K |
| 8 | Mainegeneral Medical Center Augusta, ME · General Acute Care Hospital | $777K |
| 9 | Unm Hospital Albuquerque, NM · General Acute Care Hospital | $735K |
| 10 | 1003985755 | $615K |
| 11 | Phoenix Children's Hospital Phoenix, AZ · General Acute Care Hospital Children | $480K |
| 12 | 1700978558 | $238K |
| 13 | 1114948288 | $191K |
| 14 | 1679518971 | $186K |
| 15 | Long Island Jewish Medical Center New Hyde Park, NY · General Acute Care Hospital | $185K |
| 16 | 1457369381 | $182K |
| 17 | 1053321919 | $168K |
| 18 | 1063961241 | $160K |
| 19 | 1629089966 | $149K |
| 20 | 1508832833 | $140K |
Showing top 20 of 88 providers billing this code