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#7816 of 11K

0481

HCPCS Procedure Code

HCPCS code 0481 is the #7,816 most-billed Medicaid procedure code, with $10K in payments across 3,393 claims from 2018–2024. The national median cost per claim is $11.53. Costs vary widely — the 90th percentile is $136.19 per claim, 11.8× the median.

Total Paid

$10K

0.00% of all spending

Total Claims

3,393

Providers

8

Avg Cost/Claim

$3

National Cost Distribution

How much do providers bill per claim for 0481? Based on 3 providers billing this code nationally.

Median

$11.53

Average

$59.70

Std Dev

$93.41

Max

$167.36

Percentile Distribution (Cost per Claim)

p10
$2.48
p25
$5.87
Median
$11.53
p75
$89.45
p90
$136.19
p95
$151.78
p99
$164.24

50% of providers bill between $5.87 and $89.45 per claim for this code.

90% bill between $2.48 and $136.19.

Top 1% bill above $164.24.

About This Procedure

HCPCS code 0481 was billed by 8 providers across 3,393 claims, totaling $10K in Medicaid payments from 2018–2024. This code was used for 3,078 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$11.53

Providers Billing

3

National Spending

$10K

Avg/Median Ratio

5.18×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for 0481

#ProviderTotal Paid
1Desert Valley Hospital Llc

Victorville, CA · General Acute Care Hospital

$7K
21417901091$2K
3County Of Santa Clara

San Jose, CA · Case Manager/Care Coordinator

$563
4University Of California Irvine

Orange, CA · General Acute Care Hospital

$0
51821002007$0
61922033547$0
71790778488$0
81114547114$0

Showing top 8 of 8 providers billing this code