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#6505 of 11K

0742T

HCPCS Procedure Code

HCPCS code 0742T is the #6,505 most-billed Medicaid procedure code, with $60K in payments across 1,034 claims from 2018–2024. The national median cost per claim is $42.75. Costs vary widely — the 90th percentile is $172.63 per claim, 4.0× the median.

Total Paid

$60K

0.00% of all spending

Total Claims

1,034

Providers

3

Avg Cost/Claim

$58

National Cost Distribution

How much do providers bill per claim for 0742T? Based on 3 providers billing this code nationally.

Median

$42.75

Average

$83.01

Std Dev

$107.75

Max

$205.10

Percentile Distribution (Cost per Claim)

p10
$9.50
p25
$21.97
Median
$42.75
p75
$123.92
p90
$172.63
p95
$188.87
p99
$201.85

50% of providers bill between $21.97 and $123.92 per claim for this code.

90% bill between $9.50 and $172.63.

Top 1% bill above $201.85.

About This Procedure

HCPCS code 0742T was billed by 3 providers across 1,034 claims, totaling $60K in Medicaid payments from 2018–2024. This code was used for 1,029 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$42.75

Providers Billing

3

National Spending

$60K

Avg/Median Ratio

1.94×

Moderately skewed

Provider Coverage

We have 3 providers billing this code in our dataset. Individual provider breakdowns are available for top-spending procedure codes.

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