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

#4124 of 11K

36247

HCPCS Procedure Code

HCPCS code 36247 is the #4,124 most-billed Medicaid procedure code, with $829K in payments across 3,818 claims from 2018–2024. The national median cost per claim is $128.55. Costs vary widely — the 90th percentile is $635.21 per claim, 4.9× the median.

Total Paid

$829K

0.00% of all spending

Total Claims

3,818

Providers

36

Avg Cost/Claim

$217

National Cost Distribution

How much do providers bill per claim for 36247? Based on 33 providers billing this code nationally.

Median

$128.55

Average

$295.90

Std Dev

$372.55

Max

$1,697.89

Percentile Distribution (Cost per Claim)

p10
$15.15
p25
$47.04
Median
$128.55
p75
$448.26
p90
$635.21
p95
$965.82
p99
$1,513.56

50% of providers bill between $47.04 and $448.26 per claim for this code.

90% bill between $15.15 and $635.21.

Top 1% bill above $1,513.56.

About This Procedure

HCPCS code 36247 was billed by 36 providers across 3,818 claims, totaling $829K in Medicaid payments from 2018–2024. This code was used for 2,968 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$128.55

Providers Billing

33

National Spending

$829K

Avg/Median Ratio

2.30×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for 36247

#ProviderTotal Paid
11811939465$120K
2Lsu Health Sciences Center Shreveport Faculty Group Practice

Shreveport, LA · Oral & Maxillofacial Surgery

$108K
3University Of Washington

Seattle, WA · Clinic/Center, Dental

$102K
41568803047$62K
51083680003$53K
61598792632$48K
71962731745$47K
81326487513$38K
91235411349$37K
101922070457$33K
111336219849$27K
121982115457$22K
131003298340$19K
141033230347$17K
15Medstar Washington Hospital Center

Washington, DC · General Acute Care Hospital

$15K
161316580996$13K
171063926962$11K
181255899704$11K
191235645607$10K
201275083511$9K

Showing top 20 of 36 providers billing this code