16020
HCPCS Procedure Code
HCPCS code 16020 is the #1,915 most-billed Medicaid procedure code, with $11.7M in payments across 106K claims from 2018–2024. The national median cost per claim is $52.02. Costs vary widely — the 90th percentile is $222.55 per claim, 4.3× the median.
Total Paid
$11.7M
0.00% of all spending
Total Claims
106K
Providers
157
Avg Cost/Claim
$110
National Cost Distribution
How much do providers bill per claim for 16020? Based on 147 providers billing this code nationally.
Median
$52.02
Average
$94.32
Std Dev
$108.04
Max
$579.63
Percentile Distribution (Cost per Claim)
50% of providers bill between $29.83 and $119.99 per claim for this code.
90% bill between $17.28 and $222.55.
Top 1% bill above $488.48.
About This Procedure
HCPCS code 16020 was billed by 157 providers across 106K claims, totaling $11.7M in Medicaid payments from 2018–2024. This code was used for 70K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$52.02
Providers Billing
147
National Spending
$11.7M
Avg/Median Ratio
1.81×
Moderately skewed
Top Providers Billing This Code
Ranked by total Medicaid payments for 16020
| # | Provider | Total Paid |
|---|---|---|
| 1 | Maricopa County Special Health Care District Phoenix, AZ · General Acute Care Hospital | $1.8M |
| 2 | 1598766495 | $1.5M |
| 3 | 1114958584 | $805K |
| 4 | 1114053782 | $680K |
| 5 | 1962537407 | $638K |
| 6 | Hennepin Healthcare System Inc Minneapolis, MN · General Acute Care Hospital | $539K |
| 7 | Medical University Hospital Authority Charleston, SC · General Acute Care Hospital | $481K |
| 8 | Children's Hospital Medical Center Of Akron Akron, OH · General Acute Care Hospital Children | $424K |
| 9 | Children's Hospital Washington, DC · General Acute Care Hospital Children | $332K |
| 10 | The New York And Presbyterian Hospital New York, NY · General Acute Care Hospital | $328K |
| 11 | 1548393127 | $269K |
| 12 | 1912951963 | $257K |
| 13 | Vhs Childrens Hospital Of Michigan Inc Detroit, MI · Clinic/Center, Ambulatory Surgical | $229K |
| 14 | State University Of Iowa Iowa City, IA · General Acute Care Hospital | $196K |
| 15 | Sage River Counseling Seattle, WA · Counselor Mental Health | $195K |
| 16 | The Children's Mercy Hospital Kansas City, MO · General Acute Care Hospital Children | $194K |
| 17 | 1306897335 | $183K |
| 18 | The Health And Hospital Corporation Of Marion County Indianapolis, IN · Psychiatric Unit | $179K |
| 19 | 1750344677 | $160K |
| 20 | Dallas County Hospital District Dallas, TX · Clinic/Center, Ambulatory Surgical | $116K |
Showing top 20 of 157 providers billing this code