0403T
HCPCS Procedure Code
HCPCS code 0403T is the #3,986 most-billed Medicaid procedure code, with $957K in payments across 13K claims from 2018–2024. The national median cost per claim is $8.32. Costs vary widely — the 90th percentile is $156.18 per claim, 18.8× the median.
Total Paid
$957K
0.00% of all spending
Total Claims
13K
Providers
12
Avg Cost/Claim
$75
National Cost Distribution
How much do providers bill per claim for 0403T? Based on 5 providers billing this code nationally.
Median
$8.32
Average
$60.45
Std Dev
$86.89
Max
$201.56
Percentile Distribution (Cost per Claim)
50% of providers bill between $2.76 and $88.12 per claim for this code.
90% bill between $2.00 and $156.18.
Top 1% bill above $197.02.
About This Procedure
HCPCS code 0403T was billed by 12 providers across 13K claims, totaling $957K in Medicaid payments from 2018–2024. This code was used for 12K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$8.32
Providers Billing
5
National Spending
$957K
Avg/Median Ratio
7.27×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for 0403T
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1770928384 | $896K |
| 2 | 1134343213 | $58K |
| 3 | 1144692872 | $3K |
| 4 | 1851784318 | $216 |
| 5 | 1346225927 | $152 |
| 6 | 1851364806 | $0 |
| 7 | 1477673077 | $0 |
| 8 | 1891937157 | $0 |
| 9 | 1336439090 | $0 |
| 10 | 1194871152 | $0 |
| 11 | 1538300686 | $0 |
| 12 | 1215547526 | $0 |
Showing top 12 of 12 providers billing this code