#1245 of 11K

0270

HCPCS Procedure Code

HCPCS code 0270 is the #1,245 most-billed Medicaid procedure code, with $31.5M in payments across 4.2M claims from 2018–2024. The national median cost per claim is $5.50. Costs vary widely — the 90th percentile is $34.18 per claim, 6.2× the median.

Total Paid

$31.5M

0.00% of all spending

Total Claims

4.2M

Providers

482

Avg Cost/Claim

National Cost Distribution

How much do providers bill per claim for 0270? Based on 370 providers billing this code nationally.

Median

$5.50

Average

$17.37

Std Dev

$52.65

Max

$780.53

Percentile Distribution (Cost per Claim)

p10

$0.33

p25

$1.69

Median

$5.50

p75

$12.54

p90

$34.18

p95

$67.79

p99

$210.95

50% of providers bill between $1.69 and $12.54 per claim for this code.

90% bill between $0.33 and $34.18.

Top 1% bill above $210.95.

About This Procedure

HCPCS code 0270 was billed by 482 providers across 4.2M claims, totaling $31.5M in Medicaid payments from 2018–2024. This code was used for 2.4M unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$5.50

Providers Billing

370

National Spending

$31.5M

Avg/Median Ratio

3.16×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for 0270

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	Antelope Valley Health Care District Lancaster, CA · General Acute Care Hospital	$2.2M	$70.85	12.9× median	Top 10%
2	1043215379	$1.5M	$47.11	8.6× median	Top 10%
3	1811946734	$1.5M	$34.01	6.2× median	Above 75th
4	1265433551	$891K	$21.05	3.8× median	Above 75th
5	1285688267	$877K	$11.85	2.2× median	Above Median
6	1023000569	$852K	$18.05	3.3× median	Above 75th
7	1699129601	$845K	$38.02	6.9× median	Top 10%
8	1184654923	$789K	$44.34	8.1× median	Top 10%
9	Childrens Hospital Of Los Angeles Los Angeles, CA · Case Manager/Care Coordinator	$784K	$10.57	1.9× median	Above Median
10	1437103777	$672K	$32.71	5.9× median	Above 75th
11	1639143381	$544K	$20.15	3.7× median	Above 75th
12	1730171265	$512K	$13.25	2.4× median	Above 75th
13	1467560599	$508K	$9.98	1.8× median	Above Median
14	1962442012	$503K	$8.31	1.5× median	Above Median
15	Keck Medical Center Of Usc Los Angeles, CA · General Acute Care Hospital	$482K	$210.18	38.2× median	Top 10%
16	1972541498	$476K	$12.07	2.2× median	Above Median
17	Palomar Health Escondido, CA · General Acute Care Hospital	$465K	$46.46	8.4× median	Top 10%
18	Bakersfield Memorial Hospital Bakersfield, CA · General Acute Care Hospital	$459K	$17.90	3.3× median	Above 75th
19	1639172372	$441K	$82.91	15.1× median	Top 10%
20	1427123132	$438K	$42.60	7.7× median	Top 10%

Showing top 20 of 482 providers billing this code

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