12004
HCPCS Procedure Code
HCPCS code 12004 is the #7,752 most-billed Medicaid procedure code, with $11K in payments across 171 claims from 2018–2024. The national median cost per claim is $90.82.
Total Paid
$11K
0.00% of all spending
Total Claims
171
Providers
5
Avg Cost/Claim
$63
National Cost Distribution
How much do providers bill per claim for 12004? Based on 4 providers billing this code nationally.
Median
$90.82
Average
$89.88
Std Dev
$35.24
Max
$131.17
Percentile Distribution (Cost per Claim)
50% of providers bill between $73.23 and $107.47 per claim for this code.
90% bill between $57.30 and $121.69.
Top 1% bill above $130.22.
About This Procedure
HCPCS code 12004 was billed by 5 providers across 171 claims, totaling $11K in Medicaid payments from 2018–2024. This code was used for 171 unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$90.82
Providers Billing
4
National Spending
$11K
Avg/Median Ratio
0.99×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for 12004
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1558452730 | $5K |
| 2 | 1093756025 | $3K |
| 3 | 1710073390 | $3K |
| 4 | 1225083595 | $747 |
| 5 | 1487677159 | $0 |
Showing top 5 of 5 providers billing this code