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#4638 of 11K

0851

HCPCS Procedure Code

HCPCS code 0851 is the #4,638 most-billed Medicaid procedure code, with $475K in payments across 6K claims from 2018–2024. The national median cost per claim is $54.96. Costs vary widely — the 90th percentile is $1,112.86 per claim, 20.2× the median.

Total Paid

$475K

0.00% of all spending

Total Claims

6K

Providers

5

Avg Cost/Claim

$77

National Cost Distribution

How much do providers bill per claim for 0851? Based on 3 providers billing this code nationally.

Median

$54.96

Average

$489.31

Std Dev

$769.12

Max

$1,377.34

Percentile Distribution (Cost per Claim)

p10
$39.50
p25
$45.30
Median
$54.96
p75
$716.15
p90
$1,112.86
p95
$1,245.10
p99
$1,350.89

50% of providers bill between $45.30 and $716.15 per claim for this code.

90% bill between $39.50 and $1,112.86.

Top 1% bill above $1,350.89.

About This Procedure

HCPCS code 0851 was billed by 5 providers across 6K claims, totaling $475K in Medicaid payments from 2018–2024. This code was used for 973 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$54.96

Providers Billing

3

National Spending

$475K

Avg/Median Ratio

8.90×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for 0851

#ProviderTotal Paid
11851851117$229K
21376859108$204K
31235594656$43K
41962461418$0
51639132772$0

Showing top 5 of 5 providers billing this code