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#5424 of 11K

31256

HCPCS Procedure Code

HCPCS code 31256 is the #5,424 most-billed Medicaid procedure code, with $202K in payments across 320 claims from 2018–2024. The national median cost per claim is $111.01. Costs vary widely — the 90th percentile is $1,665.61 per claim, 15.0× the median.

Total Paid

$202K

0.00% of all spending

Total Claims

320

Providers

9

Avg Cost/Claim

$632

National Cost Distribution

How much do providers bill per claim for 31256? Based on 9 providers billing this code nationally.

Median

$111.01

Average

$468.00

Std Dev

$701.37

Max

$1,762.86

Percentile Distribution (Cost per Claim)

p10
$86.71
p25
$97.64
Median
$111.01
p75
$201.23
p90
$1,665.61
p95
$1,714.23
p99
$1,753.13

50% of providers bill between $97.64 and $201.23 per claim for this code.

90% bill between $86.71 and $1,665.61.

Top 1% bill above $1,753.13.

About This Procedure

HCPCS code 31256 was billed by 9 providers across 320 claims, totaling $202K in Medicaid payments from 2018–2024. This code was used for 270 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$111.01

Providers Billing

9

National Spending

$202K

Avg/Median Ratio

4.22×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for 31256

#ProviderTotal Paid
11720390289$116K
21154310514$62K
31386648798$8K
41710901178$5K
5Lsu Health Sciences Center Shreveport Faculty Group Practice

Shreveport, LA · Oral & Maxillofacial Surgery

$4K
61194060350$3K
71629398219$2K
81083759641$1K
91942489042$746

Showing top 9 of 9 providers billing this code