#4393 of 11K

0410

HCPCS Procedure Code

HCPCS code 0410 is the #4,393 most-billed Medicaid procedure code, with $616K in payments across 27K claims from 2018–2024. The national median cost per claim is $11.44. Costs vary widely — the 90th percentile is $169.52 per claim, 14.8× the median.

Total Paid

$616K

0.00% of all spending

Total Claims

27K

Providers

Avg Cost/Claim

$23

National Cost Distribution

How much do providers bill per claim for 0410? Based on 24 providers billing this code nationally.

Median

$11.44

Average

$67.29

Std Dev

$165.45

Max

$756.10

Percentile Distribution (Cost per Claim)

p10

$0.10

p25

$1.45

Median

$11.44

p75

$20.31

p90

$169.52

p95

$306.69

p99

$657.95

50% of providers bill between $1.45 and $20.31 per claim for this code.

90% bill between $0.10 and $169.52.

Top 1% bill above $657.95.

About This Procedure

HCPCS code 0410 was billed by 57 providers across 27K claims, totaling $616K in Medicaid payments from 2018–2024. This code was used for 24K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$11.44

Providers Billing

National Spending

$616K

Avg/Median Ratio

5.88×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for 0410

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1710065933	$301K	$329.36	28.8× median	Top 10%
2	Grossmont Hospital Corporation La Mesa, CA · General Acute Care Hospital	$190K	$756.10	66.1× median	Top 1%
3	Palomar Health Escondido, CA · General Acute Care Hospital	$76K	$178.23	15.6× median	Top 10%
4	Kaiser Foundation Health Plan Inc Oakland, CA · Health Maintenance Organization	$8K	$149.19	13.0× median	Above 75th
5	1578529285	$7K	$23.18	2.0× median	Above 75th
6	County Of Santa Clara San Jose, CA · Case Manager/Care Coordinator	$6K	$1.70	0.1× median	Below Median
7	1407813660	$5K	$19.35	1.7× median	Above Median
8	1487697215	$5K	$11.79	1.0× median	Above Median
9	1093892275	$4K	$8.41	0.7× median	Below Median
10	1114547114	$4K	$19.22	1.7× median	Above Median
11	1194711952	$3K	$19.14	1.7× median	Above Median
12	1821250762	$2K	$7.50	0.7× median	Below Median
13	1104906569	$2K	$39.45	3.4× median	Above 75th
14	Childrens Hospital Of Los Angeles Los Angeles, CA · Case Manager/Care Coordinator	$810	$0.65	0.1× median	Below Median
15	Central Valley Specialty Hospital Inc Modesto, CA · General Acute Care Hospital	$688	$0.24	0.0× median	Below Median
16	1396778197	$654	$17.20	1.5× median	Above Median
17	1639101116	$215	$14.31	1.3× median	Above Median
18	1801366711	$166	$11.08	1.0× median	Below Median
19	1710109186	$146	$4.43	0.4× median	Below Median
20	1477587632	$142	$0.69	0.1× median	Below Median

Showing top 20 of 57 providers billing this code

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