#4096 of 11K

31615

HCPCS Procedure Code

HCPCS code 31615 is the #4,096 most-billed Medicaid procedure code, with $854K in payments across 9,682 claims from 2018–2024. The national median cost per claim is $95.99. Costs vary widely — the 90th percentile is $452.56 per claim, 4.7× the median.

Total Paid

$854K

0.00% of all spending

Total Claims

9,682

Providers

Avg Cost/Claim

$88

National Cost Distribution

How much do providers bill per claim for 31615? Based on 41 providers billing this code nationally.

Median

$95.99

Average

$235.92

Std Dev

$410.96

Max

$1,894.35

Percentile Distribution (Cost per Claim)

p10

$57.15

p25

$68.56

Median

$95.99

p75

$215.62

p90

$452.56

p95

$829.56

p99

$1,885.71

50% of providers bill between $68.56 and $215.62 per claim for this code.

90% bill between $57.15 and $452.56.

Top 1% bill above $1,885.71.

About This Procedure

HCPCS code 31615 was billed by 41 providers across 9,682 claims, totaling $854K in Medicaid payments from 2018–2024. This code was used for 9,166 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$95.99

Providers Billing

National Spending

$854K

Avg/Median Ratio

2.46×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for 31615

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1437220050	$110K	$68.50	0.7× median	Below Median
2	1376044784	$94K	$120.71	1.3× median	Above Median
3	Virginia Commonwealth University Health System Authority Richmond, VA · General Acute Care Hospital	$81K	$1,894.35	19.7× median	Top 1%
4	Regents Of The University Of Michigan Ann Arbor, MI · Clinic/Center, End-Stage Renal Disease (ESRD) Treatment	$77K	$243.13	2.5× median	Above 75th
5	1386162949	$61K	$226.12	2.4× median	Above 75th
6	1093024101	$57K	$149.93	1.6× median	Above Median
7	Rector & Visitors Of The University Of Virginia Charlottesville, VA · General Acute Care Hospital	$54K	$1,872.74	19.5× median	Top 10%
8	1235314980	$54K	$231.56	2.4× median	Above 75th
9	1679660617	$41K	$452.56	4.7× median	Above 75th
10	1033133525	$34K	$62.52	0.7× median	Below Median
11	1457315715	$26K	$73.38	0.8× median	Below Median
12	1073827101	$24K	$57.15	0.6× median	Below Median
13	The Cleveland Clinic Foundation Cleveland, OH · General Acute Care Hospital	$22K	$829.56	8.6× median	Top 10%
14	1275583205	$16K	$219.33	2.3× median	Above 75th
15	1245597251	$12K	$68.56	0.7× median	Below Median
16	University Of Cincinnati Medical Center, Llc Cincinnati, OH · General Acute Care Hospital	$10K	$681.70	7.1× median	Top 10%
17	Texas Children's Physician Group Houston, TX · Pediatrics	$10K	$103.07	1.1× median	Above Median
18	1639189236	$9K	$169.17	1.8× median	Above Median
19	1124118229	$7K	$119.98	1.2× median	Above Median
20	1568722858	$6K	$64.13	0.7× median	Below Median

Showing top 20 of 41 providers billing this code

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