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#4910 of 11K

0471

HCPCS Procedure Code

HCPCS code 0471 is the #4,910 most-billed Medicaid procedure code, with $357K in payments across 9,410 claims from 2018–2024. The national median cost per claim is $11.58. Costs vary widely — the 90th percentile is $97.49 per claim, 8.4× the median.

Total Paid

$357K

0.00% of all spending

Total Claims

9,410

Providers

14

Avg Cost/Claim

$38

National Cost Distribution

How much do providers bill per claim for 0471? Based on 6 providers billing this code nationally.

Median

$11.58

Average

$36.66

Std Dev

$47.75

Max

$98.90

Percentile Distribution (Cost per Claim)

p10
$0.91
p25
$1.81
Median
$11.58
p75
$77.34
p90
$97.49
p95
$98.19
p99
$98.76

50% of providers bill between $1.81 and $77.34 per claim for this code.

90% bill between $0.91 and $97.49.

Top 1% bill above $98.76.

About This Procedure

HCPCS code 0471 was billed by 14 providers across 9,410 claims, totaling $357K in Medicaid payments from 2018–2024. This code was used for 7,330 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$11.58

Providers Billing

6

National Spending

$357K

Avg/Median Ratio

3.17×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for 0471

#ProviderTotal Paid
11902803315$351K
21578529285$2K
31477596583$2K
4Childrens Hospital Of Los Angeles

Los Angeles, CA · Case Manager/Care Coordinator

$1K
51487697215$456
61336328244$43
7North East Medical Services

San Francisco, CA · Case Manager/Care Coordinator

$0
81518940667$0
91982629440$0
101760510937$0
111477502797$0
121124173059$0
131992779417$0
141932197258$0

Showing top 14 of 14 providers billing this code