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#4855 of 11K

31276

HCPCS Procedure Code

HCPCS code 31276 is the #4,855 most-billed Medicaid procedure code, with $372K in payments across 255 claims from 2018–2024. The national median cost per claim is $277.39. Costs vary widely — the 90th percentile is $3,173.28 per claim, 11.4× the median.

Total Paid

$372K

0.00% of all spending

Total Claims

255

Providers

6

Avg Cost/Claim

$1K

National Cost Distribution

How much do providers bill per claim for 31276? Based on 6 providers billing this code nationally.

Median

$277.39

Average

$1,204.88

Std Dev

$1,960.58

Max

$5,118.66

Percentile Distribution (Cost per Claim)

p10
$163.97
p25
$172.28
Median
$277.39
p75
$1,011.00
p90
$3,173.28
p95
$4,145.97
p99
$4,924.12

50% of providers bill between $172.28 and $1,011.00 per claim for this code.

90% bill between $163.97 and $3,173.28.

Top 1% bill above $4,924.12.

About This Procedure

HCPCS code 31276 was billed by 6 providers across 255 claims, totaling $372K in Medicaid payments from 2018–2024. This code was used for 230 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$277.39

Providers Billing

6

National Spending

$372K

Avg/Median Ratio

4.34×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for 31276

#ProviderTotal Paid
11154310514$189K
21306843222$163K
31194060350$10K
41336362722$5K
51679509962$3K
61942489042$2K

Showing top 6 of 6 providers billing this code

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