Statistical flags indicate unusual patterns — not proof of fraud or wrongdoing. Read our methodology

#2250 of 11K

0272

HCPCS Procedure Code

HCPCS code 0272 is the #2,250 most-billed Medicaid procedure code, with $7.4M in payments across 414K claims from 2018–2024. The national median cost per claim is $6.04. Costs vary widely — the 90th percentile is $80.23 per claim, 13.3× the median.

Total Paid

$7.4M

0.00% of all spending

Total Claims

414K

Providers

260

Avg Cost/Claim

$18

National Cost Distribution

How much do providers bill per claim for 0272? Based on 189 providers billing this code nationally.

Median

$6.04

Average

$43.46

Std Dev

$246.56

Max

$3,325.01

Percentile Distribution (Cost per Claim)

p10
$0.18
p25
$1.47
Median
$6.04
p75
$18.36
p90
$80.23
p95
$124.49
p99
$367.37

50% of providers bill between $1.47 and $18.36 per claim for this code.

90% bill between $0.18 and $80.23.

Top 1% bill above $367.37.

About This Procedure

HCPCS code 0272 was billed by 260 providers across 414K claims, totaling $7.4M in Medicaid payments from 2018–2024. This code was used for 360K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$6.04

Providers Billing

189

National Spending

$7.4M

Avg/Median Ratio

7.20×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for 0272

#ProviderTotal Paid
11801821376$699K
21740215219$565K
31477610640$554K
4Keck Medical Center Of Usc

Los Angeles, CA · General Acute Care Hospital

$425K
51073665360$407K
61154368116$395K
71992736599$266K
8Stanford Health Care

Stanford, CA · General Acute Care Hospital

$248K
91952546616$236K
101215927470$210K
11Antelope Valley Health Care District

Lancaster, CA · General Acute Care Hospital

$202K
121639172372$199K
131578529285$179K
141114081056$161K
15Children's Hospital & Research Center At Oakland

Oakland, CA · General Acute Care Hospital

$129K
161770728438$115K
171114971660$111K
181013981554$105K
191639523004$103K
201184654923$102K

Showing top 20 of 260 providers billing this code