0402
HCPCS Procedure Code
HCPCS code 0402 is the #4,326 most-billed Medicaid procedure code, with $662K in payments across 50K claims from 2018–2024. The national median cost per claim is $9.36. Costs vary widely — the 90th percentile is $173.04 per claim, 18.5× the median.
Total Paid
$662K
0.00% of all spending
Total Claims
50K
Providers
77
Avg Cost/Claim
$13
National Cost Distribution
How much do providers bill per claim for 0402? Based on 26 providers billing this code nationally.
Median
$9.36
Average
$60.56
Std Dev
$99.16
Max
$424.61
Percentile Distribution (Cost per Claim)
50% of providers bill between $1.21 and $66.82 per claim for this code.
90% bill between $0.23 and $173.04.
Top 1% bill above $378.39.
About This Procedure
HCPCS code 0402 was billed by 77 providers across 50K claims, totaling $662K in Medicaid payments from 2018–2024. This code was used for 42K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$9.36
Providers Billing
26
National Spending
$662K
Avg/Median Ratio
6.47×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for 0402
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1760510937 | $212K |
| 2 | 1194711952 | $170K |
| 3 | 1710065933 | $58K |
| 4 | 1881760452 | $49K |
| 5 | Grossmont Hospital Corporation La Mesa, CA · General Acute Care Hospital | $49K |
| 6 | University Of California Irvine Orange, CA · General Acute Care Hospital | $38K |
| 7 | 1801366711 | $37K |
| 8 | 1639523004 | $27K |
| 9 | Sharp Chula Vista Medical Center Chula Vista, CA · General Acute Care Hospital | $6K |
| 10 | 1578529285 | $5K |
| 11 | 1417901091 | $4K |
| 12 | Kaiser Foundation Health Plan Inc Oakland, CA · Health Maintenance Organization | $2K |
| 13 | 1487697215 | $2K |
| 14 | 1396778197 | $1K |
| 15 | 1932197258 | $975 |
| 16 | 1225038136 | $654 |
| 17 | 1114081056 | $254 |
| 18 | 1184628919 | $198 |
| 19 | 1336328244 | $184 |
| 20 | 1891938122 | $139 |
Showing top 20 of 77 providers billing this code