#5679 of 11K

31628

HCPCS Procedure Code

HCPCS code 31628 is the #5,679 most-billed Medicaid procedure code, with $156K in payments across 804 claims from 2018–2024. The national median cost per claim is $106.31. Costs vary widely — the 90th percentile is $358.37 per claim, 3.4× the median.

Total Paid

$156K

0.00% of all spending

Total Claims

804

Providers

Avg Cost/Claim

$194

National Cost Distribution

How much do providers bill per claim for 31628? Based on 17 providers billing this code nationally.

Median

$106.31

Average

$171.10

Std Dev

$148.75

Max

$515.21

Percentile Distribution (Cost per Claim)

p10

$38.55

p25

$66.52

Median

$106.31

p75

$308.63

p90

$358.37

p95

$433.69

p99

$498.91

50% of providers bill between $66.52 and $308.63 per claim for this code.

90% bill between $38.55 and $358.37.

Top 1% bill above $498.91.

About This Procedure

HCPCS code 31628 was billed by 17 providers across 804 claims, totaling $156K in Medicaid payments from 2018–2024. This code was used for 695 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$106.31

Providers Billing

National Spending

$156K

Avg/Median Ratio

1.61×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for 31628

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	University Of Kentucky Lexington, KY · General Acute Care Hospital	$38K	$413.30	3.9× median	Top 10%
2	The Cleveland Clinic Foundation Cleveland, OH · General Acute Care Hospital	$33K	$321.74	3.0× median	Above 75th
3	1003981549	$18K	$146.60	1.4× median	Above Median
4	Yale New Haven Hospital New Haven, CT · General Acute Care Hospital	$16K	$317.32	3.0× median	Above 75th
5	The New York And Presbyterian Hospital New York, NY · General Acute Care Hospital	$10K	$187.86	1.8× median	Above Median
6	1568566131	$8K	$127.91	1.2× median	Above Median
7	1225041809	$8K	$515.21	4.8× median	Top 1%
8	1326091448	$6K	$94.24	0.9× median	Below Median
9	Our Lady Of The Lake Physician Group Llc Baton Rouge, LA · Allergy & Immunology	$4K	$68.02	0.6× median	Below Median
10	Dignity Health Phoenix, AZ · Rehabilitation Unit	$4K	$308.63	2.9× median	Above Median
11	1639172372	$2K	$89.16	0.8× median	Below Median
12	1043260474	$2K	$42.73	0.4× median	Below Median
13	Ohio State University Hospitals Columbus, OH · General Acute Care Hospital	$1K	$66.52	0.6× median	Below Median
14	1437292927	$1K	$106.31	1.0× median	Below Median
15	1790868297	$1K	$47.02	0.4× median	Below Median
16	Saint Francis Hospital And Medical Center Hartford, CT · General Acute Care Hospital	$743	$32.28	0.3× median	Below Median
17	1003882812	$286	$23.87	0.2× median	Below Median

Showing top 17 of 17 providers billing this code

Related Procedures

31622$11.3M 31624$5.1M 31623$240K 31629$24K 31627$19K

← All procedures Top providers →