#3420 of 11K

0503F

HCPCS Procedure Code

HCPCS code 0503F is the #3,420 most-billed Medicaid procedure code, with $1.7M in payments across 234K claims from 2018–2024. The national median cost per claim is $10.68. Costs vary widely — the 90th percentile is $68.87 per claim, 6.4× the median.

Total Paid

$1.7M

0.00% of all spending

Total Claims

234K

Providers

772

Avg Cost/Claim

National Cost Distribution

How much do providers bill per claim for 0503F? Based on 349 providers billing this code nationally.

Median

$10.68

Average

$27.18

Std Dev

$32.75

Max

$243.86

Percentile Distribution (Cost per Claim)

p10

$0.00

p25

$0.91

Median

$10.68

p75

$50.15

p90

$68.87

p95

$89.22

p99

$114.20

50% of providers bill between $0.91 and $50.15 per claim for this code.

90% bill between $0.00 and $68.87.

Top 1% bill above $114.20.

About This Procedure

HCPCS code 0503F was billed by 772 providers across 234K claims, totaling $1.7M in Medicaid payments from 2018–2024. This code was used for 196K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$10.68

Providers Billing

349

National Spending

$1.7M

Avg/Median Ratio

2.54×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for 0503F

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1063459410	$97K	$32.54	3.0× median	Above Median
2	1952749483	$54K	$33.79	3.2× median	Above Median
3	1457848954	$52K	$63.93	6.0× median	Above 75th
4	1316029663	$52K	$63.05	5.9× median	Above 75th
5	1518303262	$51K	$25.90	2.4× median	Above Median
6	1316988389	$50K	$54.53	5.1× median	Above 75th
7	1609095108	$46K	$23.95	2.2× median	Above Median
8	1669768644	$46K	$57.65	5.4× median	Above 75th
9	1184676157	$39K	$27.61	2.6× median	Above Median
10	1164789467	$35K	$33.60	3.1× median	Above Median
11	1851307532	$35K	$34.40	3.2× median	Above Median
12	1952499014	$35K	$58.38	5.5× median	Above 75th
13	1275567588	$33K	$24.08	2.3× median	Above Median
14	1437194669	$32K	$7.23	0.7× median	Below Median
15	1801861380	$29K	$56.52	5.3× median	Above 75th
16	1548664840	$28K	$24.15	2.3× median	Above Median
17	1770914673	$27K	$27.46	2.6× median	Above Median
18	1477534428	$26K	$62.52	5.9× median	Above 75th
19	1962456574	$25K	$51.38	4.8× median	Above 75th
20	1952406639	$25K	$74.20	6.9× median	Top 10%

Showing top 20 of 772 providers billing this code

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