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#3645 of 11K

40819

HCPCS Procedure Code

HCPCS code 40819 is the #3,645 most-billed Medicaid procedure code, with $1.4M in payments across 6,616 claims from 2018–2024. The national median cost per claim is $159.02. Costs vary widely — the 90th percentile is $447.81 per claim, 2.8× the median.

Total Paid

$1.4M

0.00% of all spending

Total Claims

6,616

Providers

18

Avg Cost/Claim

$209

National Cost Distribution

How much do providers bill per claim for 40819? Based on 18 providers billing this code nationally.

Median

$159.02

Average

$285.10

Std Dev

$370.62

Max

$1,602.06

Percentile Distribution (Cost per Claim)

p10
$112.68
p25
$138.98
Median
$159.02
p75
$228.12
p90
$447.81
p95
$970.99
p99
$1,475.85

50% of providers bill between $138.98 and $228.12 per claim for this code.

90% bill between $112.68 and $447.81.

Top 1% bill above $1,475.85.

About This Procedure

HCPCS code 40819 was billed by 18 providers across 6,616 claims, totaling $1.4M in Medicaid payments from 2018–2024. This code was used for 5,544 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$159.02

Providers Billing

18

National Spending

$1.4M

Avg/Median Ratio

1.79×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for 40819

#ProviderTotal Paid
11629076518$468K
21275809394$336K
3Childrens Hospital Of The Kings Daughters Inc

Norfolk, VA · Social Worker, Clinical

$176K
41306155353$106K
51851423883$71K
61265095780$41K
71649453275$37K
8Suny Health Science Center At Syracuse

Syracuse, NY · General Acute Care Hospital

$35K
91679851455$33K
101508002072$22K
111083824684$11K
121699819979$10K
131932567468$8K
141366685810$8K
151952525636$8K
161255352266$6K
171144568999$4K
181497758155$2K

Showing top 18 of 18 providers billing this code

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