#3492 of 11K

0637

HCPCS Procedure Code

HCPCS code 0637 is the #3,492 most-billed Medicaid procedure code, with $1.6M in payments across 2.2M claims from 2018–2024. The national median cost per claim is $0.57. Costs vary widely — the 90th percentile is $5.22 per claim, 9.2× the median.

Total Paid

$1.6M

0.00% of all spending

Total Claims

2.2M

Providers

112

Avg Cost/Claim

National Cost Distribution

How much do providers bill per claim for 0637? Based on 94 providers billing this code nationally.

Median

$0.57

Average

$1.87

Std Dev

$3.11

Max

$17.71

Percentile Distribution (Cost per Claim)

p10

$0.09

p25

$0.20

Median

$0.57

p75

$1.90

p90

$5.22

p95

$8.29

p99

$14.10

50% of providers bill between $0.20 and $1.90 per claim for this code.

90% bill between $0.09 and $5.22.

Top 1% bill above $14.10.

About This Procedure

HCPCS code 0637 was billed by 112 providers across 2.2M claims, totaling $1.6M in Medicaid payments from 2018–2024. This code was used for 806K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$0.57

Providers Billing

National Spending

$1.6M

Avg/Median Ratio

3.28×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for 0637

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	Antelope Valley Health Care District Lancaster, CA · General Acute Care Hospital	$177K	$3.97	7.0× median	Above 75th
2	1295880912	$96K	$1.94	3.4× median	Above 75th
3	Kaiser Foundation Hospitals Downey, CA · General Acute Care Hospital	$95K	$0.58	1.0× median	Above Median
4	1134274897	$95K	$1.01	1.8× median	Above Median
5	1538214556	$91K	$1.75	3.1× median	Above Median
6	1821143777	$82K	$1.07	1.9× median	Above Median
7	1720088354	$71K	$6.84	12.0× median	Top 10%
8	1407813660	$71K	$7.22	12.7× median	Top 10%
9	1356496772	$68K	$0.52	0.9× median	Below Median
10	1336294040	$68K	$0.92	1.6× median	Above Median
11	1073811378	$56K	$0.49	0.9× median	Below Median
12	1013062769	$56K	$0.39	0.7× median	Below Median
13	1467459776	$53K	$1.20	2.1× median	Above Median
14	1376698043	$52K	$0.58	1.0× median	Above Median
15	Kaiser Foundation Hospitals Baldwin Park, CA · General Acute Care Hospital	$51K	$0.56	1.0× median	Below Median
16	1013981554	$47K	$13.82	24.3× median	Top 10%
17	1063441293	$41K	$3.35	5.9× median	Above 75th
18	Kaiser Foundation Hospitals Sacramento, CA · General Acute Care Hospital	$39K	$0.27	0.5× median	Below Median
19	Kaiser Foundation Hospitals Anaheim, CA · General Acute Care Hospital	$24K	$0.27	0.5× median	Below Median
20	1346381415	$21K	$1.47	2.6× median	Above Median

Showing top 20 of 112 providers billing this code

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