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#6594 of 11K

1031F

HCPCS Procedure Code

HCPCS code 1031F is the #6,594 most-billed Medicaid procedure code, with $53K in payments across 1.0M claims from 2018–2024. The national median cost per claim is $0.04. Costs vary widely — the 90th percentile is $5.91 per claim, 147.8× the median.

Total Paid

$53K

0.00% of all spending

Total Claims

1.0M

Providers

365

Avg Cost/Claim

$0

National Cost Distribution

How much do providers bill per claim for 1031F? Based on 32 providers billing this code nationally.

Median

$0.04

Average

$3.94

Std Dev

$14.54

Max

$80.95

Percentile Distribution (Cost per Claim)

p10
$0.00
p25
$0.00
Median
$0.04
p75
$0.32
p90
$5.91
p95
$12.59
p99
$61.67

50% of providers bill between $0.00 and $0.32 per claim for this code.

90% bill between $0.00 and $5.91.

Top 1% bill above $61.67.

About This Procedure

HCPCS code 1031F was billed by 365 providers across 1.0M claims, totaling $53K in Medicaid payments from 2018–2024. This code was used for 926K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$0.04

Providers Billing

32

National Spending

$53K

Avg/Median Ratio

98.50×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for 1031F

#ProviderTotal Paid
11437508314$16K
21346266848$11K
31912377813$9K
41043387327$7K
51770697278$4K
61770950396$3K
71750657722$2K
81568706158$710
91689778623$524
101962688127$310
111093838609$175
121518001437$139
131386273100$131
141386010312$101
15La Maestra Family Clinic, Inc.

San Diego, CA · Clinic/Center, Federally Qualified Health Center (FQHC)

$68
161861440810$65
171366591695$32
181124362348$30
191790781128$25
201477845956$25

Showing top 20 of 365 providers billing this code