78227
HCPCS Procedure Code
HCPCS code 78227 is the #2,529 most-billed Medicaid procedure code, with $5.1M in payments across 33K claims from 2018–2024. The national median cost per claim is $83.57. Costs vary widely — the 90th percentile is $354.53 per claim, 4.2× the median.
Total Paid
$5.1M
0.00% of all spending
Total Claims
33K
Providers
215
Avg Cost/Claim
$157
National Cost Distribution
How much do providers bill per claim for 78227? Based on 214 providers billing this code nationally.
Median
$83.57
Average
$156.59
Std Dev
$145.93
Max
$580.88
Percentile Distribution (Cost per Claim)
50% of providers bill between $25.13 and $278.24 per claim for this code.
90% bill between $20.85 and $354.53.
Top 1% bill above $558.29.
About This Procedure
HCPCS code 78227 was billed by 215 providers across 33K claims, totaling $5.1M in Medicaid payments from 2018–2024. This code was used for 30K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$83.57
Providers Billing
214
National Spending
$5.1M
Avg/Median Ratio
1.87×
Moderately skewed
Top Providers Billing This Code
Ranked by total Medicaid payments for 78227
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1972004489 | $751K |
| 2 | Norton Hospitals Inc Louisville, KY · General Acute Care Hospital | $432K |
| 3 | Ashland Hospital Corporation Ashland, KY · Clinic/Center, Rural Health | $343K |
| 4 | Norton Hospitals, Inc Louisville, KY · General Acute Care Hospital | $193K |
| 5 | 1821135963 | $176K |
| 6 | 1770581894 | $169K |
| 7 | Baptist Healthcare System Inc Corbin, KY · General Acute Care Hospital | $168K |
| 8 | 1609869916 | $150K |
| 9 | 1427055821 | $140K |
| 10 | 1568452290 | $116K |
| 11 | 1902897820 | $114K |
| 12 | Presbyterian Healthcare Services Albuquerque, NM · Emergency Medicine | $104K |
| 13 | 1689282147 | $98K |
| 14 | Pikeville Medical Center Inc Pikeville, KY · General Acute Care Hospital | $97K |
| 15 | Tucson Medical Center Tucson, AZ · Clinic/Center, Hearing and Speech | $94K |
| 16 | Uofl Health-louisville Inc Louisville, KY · Psychiatric Hospital | $93K |
| 17 | Owensboro Health Inc Owensboro, KY · General Acute Care Hospital | $89K |
| 18 | 1427057967 | $82K |
| 19 | 1538157508 | $73K |
| 20 | 1346244126 | $68K |
Showing top 20 of 215 providers billing this code