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#4687 of 11K

38220

HCPCS Procedure Code

HCPCS code 38220 is the #4,687 most-billed Medicaid procedure code, with $449K in payments across 2,720 claims from 2018–2024. The national median cost per claim is $302.84. Costs vary widely — the 90th percentile is $732.54 per claim, 2.4× the median.

Total Paid

$449K

0.00% of all spending

Total Claims

2,720

Providers

6

Avg Cost/Claim

$165

National Cost Distribution

How much do providers bill per claim for 38220? Based on 6 providers billing this code nationally.

Median

$302.84

Average

$368.29

Std Dev

$311.17

Max

$837.23

Percentile Distribution (Cost per Claim)

p10
$69.50
p25
$152.85
Median
$302.84
p75
$558.84
p90
$732.54
p95
$784.89
p99
$826.77

50% of providers bill between $152.85 and $558.84 per claim for this code.

90% bill between $69.50 and $732.54.

Top 1% bill above $826.77.

About This Procedure

HCPCS code 38220 was billed by 6 providers across 2,720 claims, totaling $449K in Medicaid payments from 2018–2024. This code was used for 2,425 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$302.84

Providers Billing

6

National Spending

$449K

Avg/Median Ratio

1.22×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 38220

#ProviderTotal Paid
11164493847$208K
2Memorial Hospital For Cancer And Allied Diseases

New York, NY · Pharmacy

$82K
3Seattle Children's Hospital

Seattle, WA · Prosthetic/Orthotic Supplier

$82K
4Phoenix Children's Hospital

Phoenix, AZ · General Acute Care Hospital Children

$43K
51184824146$30K
61588862130$3K

Showing top 6 of 6 providers billing this code

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