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#5340 of 11K

78315

HCPCS Procedure Code

HCPCS code 78315 is the #5,340 most-billed Medicaid procedure code, with $225K in payments across 1,432 claims from 2018–2024. The national median cost per claim is $64.80. Costs vary widely — the 90th percentile is $191.21 per claim, 3.0× the median.

Total Paid

$225K

0.00% of all spending

Total Claims

1,432

Providers

10

Avg Cost/Claim

$157

National Cost Distribution

How much do providers bill per claim for 78315? Based on 10 providers billing this code nationally.

Median

$64.80

Average

$95.80

Std Dev

$85.01

Max

$257.49

Percentile Distribution (Cost per Claim)

p10
$24.43
p25
$26.82
Median
$64.80
p75
$159.38
p90
$191.21
p95
$224.35
p99
$250.86

50% of providers bill between $26.82 and $159.38 per claim for this code.

90% bill between $24.43 and $191.21.

Top 1% bill above $250.86.

About This Procedure

HCPCS code 78315 was billed by 10 providers across 1,432 claims, totaling $225K in Medicaid payments from 2018–2024. This code was used for 889 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$64.80

Providers Billing

10

National Spending

$225K

Avg/Median Ratio

1.48×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 78315

#ProviderTotal Paid
11558356493$197K
21275630527$13K
3Temple University Hospital Inc

Philadelphia, PA · General Acute Care Hospital

$5K
41184680480$4K
51912992553$2K
61740283324$1K
71487608931$1K
81386693364$790
9University Physicians Incorporated

Aurora, CO · Anesthesiology

$623
101669408159$390

Showing top 10 of 10 providers billing this code

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