31526
HCPCS Procedure Code
HCPCS code 31526 is the #2,724 most-billed Medicaid procedure code, with $4.0M in payments across 16K claims from 2018–2024. The national median cost per claim is $113.38. Costs vary widely — the 90th percentile is $1,004.17 per claim, 8.9× the median.
Total Paid
$4.0M
0.00% of all spending
Total Claims
16K
Providers
54
Avg Cost/Claim
$255
National Cost Distribution
How much do providers bill per claim for 31526? Based on 53 providers billing this code nationally.
Median
$113.38
Average
$286.95
Std Dev
$390.94
Max
$1,625.31
Percentile Distribution (Cost per Claim)
50% of providers bill between $74.55 and $218.33 per claim for this code.
90% bill between $62.42 and $1,004.17.
Top 1% bill above $1,502.25.
About This Procedure
HCPCS code 31526 was billed by 54 providers across 16K claims, totaling $4.0M in Medicaid payments from 2018–2024. This code was used for 13K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$113.38
Providers Billing
53
National Spending
$4.0M
Avg/Median Ratio
2.53×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for 31526
| # | Provider | Total Paid |
|---|---|---|
| 1 | Phoenix Children's Hospital Phoenix, AZ · General Acute Care Hospital Children | $1.6M |
| 2 | Children's Hospital Medical Center Cincinnati, OH · Clinic/Center, Primary Care | $434K |
| 3 | 1609915784 | $275K |
| 4 | Arkansas Childrens Hospital Little Rock, AR · Clinic/Center, Critical Access Hospital | $216K |
| 5 | Egleston Children's Hospital At Emory University Inc. Atlanta, GA · Pediatrics Pediatric Emergency Medicine | $184K |
| 6 | Connecticut Children's Medical Center Hartford, CT · General Acute Care Hospital, Children | $179K |
| 7 | 1114958584 | $178K |
| 8 | Children's Hospital Corporation Boston, MA · Clinic/Center | $126K |
| 9 | 1669617197 | $113K |
| 10 | 1275563447 | $80K |
| 11 | 1093024101 | $63K |
| 12 | Regents Of The University Of Michigan Ann Arbor, MI · Clinic/Center, End-Stage Renal Disease (ESRD) Treatment | $56K |
| 13 | 1861886350 | $52K |
| 14 | 1033133525 | $44K |
| 15 | University Physicians Incorporated Aurora, CO · Anesthesiology | $35K |
| 16 | 1780669200 | $32K |
| 17 | 1346230968 | $32K |
| 18 | Our Lady Of The Lake Physician Group Llc Baton Rouge, LA · Allergy & Immunology | $29K |
| 19 | Phoenix Children's Hospital Phoenix, AZ · Pediatrics | $22K |
| 20 | 1871110148 | $22K |
Showing top 20 of 54 providers billing this code