#5793 of 11K

0351

HCPCS Procedure Code

HCPCS code 0351 is the #5,793 most-billed Medicaid procedure code, with $136K in payments across 11K claims from 2018–2024. The national median cost per claim is $35.16. Costs vary widely — the 90th percentile is $238.92 per claim, 6.8× the median.

Total Paid

$136K

0.00% of all spending

Total Claims

11K

Providers

Avg Cost/Claim

$12

National Cost Distribution

How much do providers bill per claim for 0351? Based on 12 providers billing this code nationally.

Median

$35.16

Average

$104.43

Std Dev

$138.42

Max

$444.02

Percentile Distribution (Cost per Claim)

p10

$0.36

p25

$0.94

Median

$35.16

p75

$164.38

p90

$238.92

p95

$333.79

p99

$421.97

50% of providers bill between $0.94 and $164.38 per claim for this code.

90% bill between $0.36 and $238.92.

Top 1% bill above $421.97.

About This Procedure

HCPCS code 0351 was billed by 44 providers across 11K claims, totaling $136K in Medicaid payments from 2018–2024. This code was used for 10K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$35.16

Providers Billing

National Spending

$136K

Avg/Median Ratio

2.97×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for 0351

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	Grossmont Hospital Corporation La Mesa, CA · General Acute Care Hospital	$77K	$444.02	12.6× median	Top 1%
2	University Of California Irvine Orange, CA · General Acute Care Hospital	$25K	$153.61	4.4× median	Above Median
3	Kaiser Foundation Health Plan Inc Oakland, CA · Health Maintenance Organization	$11K	$243.61	6.9× median	Top 10%
4	1801366711	$7K	$63.32	1.8× median	Above Median
5	1760510937	$5K	$7.01	0.2× median	Below Median
6	1578529285	$4K	$136.97	3.9× median	Above Median
7	1194711952	$3K	$196.70	5.6× median	Above 75th
8	1336328244	$2K	$0.77	0.0× median	Below Median
9	1942247291	$1K	$5.60	0.2× median	Below Median
10	1932197258	$1K	$1.00	0.0× median	Below Median
11	County Of Santa Clara San Jose, CA · Case Manager/Care Coordinator	$621	$0.31	0.0× median	Below Median
12	1336173269	$95	$0.28	0.0× median	Below Median
13	1477502797	$0	$0.00	0.0× median	Below Median
14	1538141627	$0	$0.00	0.0× median	Below Median
15	1518951300	$0	$0.00	0.0× median	Below Median
16	1124173059	$0	$0.00	0.0× median	Below Median
17	1891938122	$0	$0.00	0.0× median	Below Median
18	Childrens Hospital Of Los Angeles Los Angeles, CA · Case Manager/Care Coordinator	$0	$0.00	0.0× median	Below Median
19	1417089350	$0	$0.00	0.0× median	Below Median
20	1427123132	$0	$0.00	0.0× median	Below Median

Showing top 20 of 44 providers billing this code

Related Procedures

0360$90.4M 0361$2.0M 0352$487K 0350$369K 0359$3K

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