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#2623 of 11K

0297T

HCPCS Procedure Code

HCPCS code 0297T is the #2,623 most-billed Medicaid procedure code, with $4.5M in payments across 70K claims from 2018–2024. The national median cost per claim is $19.09. Costs vary widely — the 90th percentile is $68.27 per claim, 3.6× the median.

Total Paid

$4.5M

0.00% of all spending

Total Claims

70K

Providers

22

Avg Cost/Claim

$65

National Cost Distribution

How much do providers bill per claim for 0297T? Based on 22 providers billing this code nationally.

Median

$19.09

Average

$34.72

Std Dev

$45.53

Max

$208.41

Percentile Distribution (Cost per Claim)

p10
$1.65
p25
$7.93
Median
$19.09
p75
$50.85
p90
$68.27
p95
$78.31
p99
$181.19

50% of providers bill between $7.93 and $50.85 per claim for this code.

90% bill between $1.65 and $68.27.

Top 1% bill above $181.19.

About This Procedure

HCPCS code 0297T was billed by 22 providers across 70K claims, totaling $4.5M in Medicaid payments from 2018–2024. This code was used for 65K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$19.09

Providers Billing

22

National Spending

$4.5M

Avg/Median Ratio

1.82×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for 0297T

#ProviderTotal Paid
11710130539$3.7M
21790869402$635K
31063414258$60K
41932697729$40K
51336245828$15K
6Nationwide Children's Hospital

Columbus, OH · General Acute Care Hospital

$9K
71467440743$8K
8University Of Washington

Seattle, WA · Clinic/Center, Dental

$5K
91356307581$4K
101326091448$2K
111104875103$1K
121801851258$1K
131306845557$1K
141306274634$986
15Children's Hospital Corporation

Boston, MA · Clinic/Center

$968
161699874248$899
171114948445$783
18Children's Hospital Of Wisconsin, Inc.

Milwaukee, WI · Dentist, Pediatric Dentistry

$294
19County Of Santa Clara

San Jose, CA · Case Manager/Care Coordinator

$165
201922043686$79

Showing top 20 of 22 providers billing this code