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

#5286 of 11K

31623

HCPCS Procedure Code

HCPCS code 31623 is the #5,286 most-billed Medicaid procedure code, with $240K in payments across 2,733 claims from 2018–2024. The national median cost per claim is $54.73. Costs vary widely — the 90th percentile is $266.47 per claim, 4.9× the median.

Total Paid

$240K

0.00% of all spending

Total Claims

2,733

Providers

11

Avg Cost/Claim

$88

National Cost Distribution

How much do providers bill per claim for 31623? Based on 10 providers billing this code nationally.

Median

$54.73

Average

$238.54

Std Dev

$572.76

Max

$1,867.39

Percentile Distribution (Cost per Claim)

p10
$27.91
p25
$46.94
Median
$54.73
p75
$84.44
p90
$266.47
p95
$1,066.93
p99
$1,707.30

50% of providers bill between $46.94 and $84.44 per claim for this code.

90% bill between $27.91 and $266.47.

Top 1% bill above $1,707.30.

About This Procedure

HCPCS code 31623 was billed by 11 providers across 2,733 claims, totaling $240K in Medicaid payments from 2018–2024. This code was used for 2,673 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$54.73

Providers Billing

10

National Spending

$240K

Avg/Median Ratio

4.36×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for 31623

#ProviderTotal Paid
11780797381$123K
21356410351$76K
31639172372$26K
41568566131$5K
51003981549$4K
6Saint Francis Hospital And Medical Center

Hartford, CT · General Acute Care Hospital

$2K
7Our Lady Of The Lake Physician Group Llc

Baton Rouge, LA · Allergy & Immunology

$2K
81871567479$2K
91316228802$537
101174744304$369
111346250594$0

Showing top 11 of 11 providers billing this code