0636
HCPCS Procedure Code
HCPCS code 0636 is the #1,728 most-billed Medicaid procedure code, with $15.2M in payments across 916K claims from 2018–2024. The national median cost per claim is $5.41. Costs vary widely — the 90th percentile is $61.18 per claim, 11.3× the median.
Total Paid
$15.2M
0.00% of all spending
Total Claims
916K
Providers
253
Avg Cost/Claim
$17
National Cost Distribution
How much do providers bill per claim for 0636? Based on 151 providers billing this code nationally.
Median
$5.41
Average
$36.25
Std Dev
$119.47
Max
$872.47
Percentile Distribution (Cost per Claim)
50% of providers bill between $0.95 and $12.33 per claim for this code.
90% bill between $0.09 and $61.18.
Top 1% bill above $706.61.
About This Procedure
HCPCS code 0636 was billed by 253 providers across 916K claims, totaling $15.2M in Medicaid payments from 2018–2024. This code was used for 463K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$5.41
Providers Billing
151
National Spending
$15.2M
Avg/Median Ratio
6.70×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for 0636
| # | Provider | Total Paid |
|---|---|---|
| 1 | Childrens Hospital Of Los Angeles Los Angeles, CA · Case Manager/Care Coordinator | $3.7M |
| 2 | 1386779270 | $1.3M |
| 3 | 1447277355 | $936K |
| 4 | 1174859425 | $899K |
| 5 | 1003102781 | $664K |
| 6 | 1548648801 | $556K |
| 7 | 1770618571 | $514K |
| 8 | 1275553257 | $452K |
| 9 | 1629377452 | $448K |
| 10 | 1235594656 | $447K |
| 11 | 1710065933 | $428K |
| 12 | 1326065103 | $427K |
| 13 | 1275550295 | $423K |
| 14 | 1841217866 | $422K |
| 15 | 1174911317 | $332K |
| 16 | 1194711952 | $288K |
| 17 | 1598064008 | $243K |
| 18 | 1124045158 | $225K |
| 19 | 1396778197 | $202K |
| 20 | 1376560151 | $202K |
Showing top 20 of 253 providers billing this code