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#4927 of 11K

78013

HCPCS Procedure Code

HCPCS code 78013 is the #4,927 most-billed Medicaid procedure code, with $351K in payments across 2,640 claims from 2018–2024. The national median cost per claim is $31.68. Costs vary widely — the 90th percentile is $123.42 per claim, 3.9× the median.

Total Paid

$351K

0.00% of all spending

Total Claims

2,640

Providers

7

Avg Cost/Claim

$133

National Cost Distribution

How much do providers bill per claim for 78013? Based on 7 providers billing this code nationally.

Median

$31.68

Average

$48.37

Std Dev

$54.78

Max

$137.47

Percentile Distribution (Cost per Claim)

p10
$4.49
p25
$7.59
Median
$31.68
p75
$75.27
p90
$123.42
p95
$130.44
p99
$136.07

50% of providers bill between $7.59 and $75.27 per claim for this code.

90% bill between $4.49 and $123.42.

Top 1% bill above $136.07.

About This Procedure

HCPCS code 78013 was billed by 7 providers across 2,640 claims, totaling $351K in Medicaid payments from 2018–2024. This code was used for 2,235 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$31.68

Providers Billing

7

National Spending

$351K

Avg/Median Ratio

1.53×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for 78013

#ProviderTotal Paid
11285603837$344K
21073003190$5K
31366484594$2K
41336192863$507
5William Beaumont Hospital

Royal Oak, MI · Internal Medicine, Cardiovascular Disease

$122
61366525487$70
71598859100$52

Showing top 7 of 7 providers billing this code

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