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#5316 of 11K

37231

HCPCS Procedure Code

HCPCS code 37231 is the #5,316 most-billed Medicaid procedure code, with $230K in payments across 731 claims from 2018–2024. The national median cost per claim is $305.23. Costs vary widely — the 90th percentile is $1,257.35 per claim, 4.1× the median.

Total Paid

$230K

0.00% of all spending

Total Claims

731

Providers

4

Avg Cost/Claim

$315

National Cost Distribution

How much do providers bill per claim for 37231? Based on 4 providers billing this code nationally.

Median

$305.23

Average

$634.17

Std Dev

$683.50

Max

$1,658.91

Percentile Distribution (Cost per Claim)

p10
$274.15
p25
$284.40
Median
$305.23
p75
$655.01
p90
$1,257.35
p95
$1,458.13
p99
$1,618.75

50% of providers bill between $284.40 and $655.01 per claim for this code.

90% bill between $274.15 and $1,257.35.

Top 1% bill above $1,618.75.

About This Procedure

HCPCS code 37231 was billed by 4 providers across 731 claims, totaling $230K in Medicaid payments from 2018–2024. This code was used for 594 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$305.23

Providers Billing

4

National Spending

$230K

Avg/Median Ratio

2.08×

Highly skewed — outlier-driven

Provider Coverage

We have 4 providers billing this code in our dataset. Individual provider breakdowns are available for top-spending procedure codes.