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#2372 of 11K

1213M

HCPCS Procedure Code

HCPCS code 1213M is the #2,372 most-billed Medicaid procedure code, with $6.3M in payments across 61K claims from 2018–2024. The national median cost per claim is $102.49.

Total Paid

$6.3M

0.00% of all spending

Total Claims

61K

Providers

10

Avg Cost/Claim

$103

National Cost Distribution

How much do providers bill per claim for 1213M? Based on 10 providers billing this code nationally.

Median

$102.49

Average

$116.57

Std Dev

$96.35

Max

$373.19

Percentile Distribution (Cost per Claim)

p10
$39.25
p25
$63.60
Median
$102.49
p75
$124.53
p90
$153.62
p95
$263.41
p99
$351.24

50% of providers bill between $63.60 and $124.53 per claim for this code.

90% bill between $39.25 and $153.62.

Top 1% bill above $351.24.

About This Procedure

HCPCS code 1213M was billed by 10 providers across 61K claims, totaling $6.3M in Medicaid payments from 2018–2024. This code was used for 3,905 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$102.49

Providers Billing

10

National Spending

$6.3M

Avg/Median Ratio

1.14×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 1213M

#ProviderTotal Paid
11346639739$2.4M
21588128813$2.0M
31922132083$1000K
41235584145$393K
51043410954$225K
61144695461$133K
71881016186$57K
81316306566$18K
91578855508$11K
101962970699$7K

Showing top 10 of 10 providers billing this code