Statistical flags indicate unusual patterns — not proof of fraud or wrongdoing. Read our methodology

#1835 of 11K

31237

HCPCS Procedure Code

HCPCS code 31237 is the #1,835 most-billed Medicaid procedure code, with $13.0M in payments across 42K claims from 2018–2024. The national median cost per claim is $211.06.

Total Paid

$13.0M

0.00% of all spending

Total Claims

42K

Providers

136

Avg Cost/Claim

$309

National Cost Distribution

How much do providers bill per claim for 31237? Based on 133 providers billing this code nationally.

Median

$211.06

Average

$272.92

Std Dev

$245.95

Max

$1,452.80

Percentile Distribution (Cost per Claim)

p10
$97.57
p25
$156.91
Median
$211.06
p75
$305.63
p90
$401.87
p95
$794.62
p99
$1,393.21

50% of providers bill between $156.91 and $305.63 per claim for this code.

90% bill between $97.57 and $401.87.

Top 1% bill above $1,393.21.

About This Procedure

HCPCS code 31237 was billed by 136 providers across 42K claims, totaling $13.0M in Medicaid payments from 2018–2024. This code was used for 31K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$211.06

Providers Billing

133

National Spending

$13.0M

Avg/Median Ratio

1.29×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 31237

#ProviderTotal Paid
11639189236$2.7M
21639101751$832K
3Montefiore Medical Center

Bronx, NY · General Acute Care Hospital

$751K
41811992761$697K
51942489042$655K
6Beth Israel Medical Center

Brooklyn, NY · Psychiatric Unit

$510K
71285716886$449K
81205229903$383K
9North Shore-lij Medical Pc

Great Neck, NY · Urology

$372K
101679660617$331K
111710113949$297K
121144227539$253K
13Banner-university Medical Group

Phoenix, AZ · Clinic/Center, Primary Care

$243K
141538302997$241K
151477957504$201K
161700966090$191K
17University Of California Irvine

Orange, CA · General Acute Care Hospital

$185K
18University Of Washington

Seattle, WA · Clinic/Center, Dental

$180K
191427536325$178K
201972630705$167K

Showing top 20 of 136 providers billing this code