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#3318 of 11K

78812

HCPCS Procedure Code

HCPCS code 78812 is the #3,318 most-billed Medicaid procedure code, with $1.9M in payments across 6K claims from 2018–2024. The national median cost per claim is $256.64. Costs vary widely — the 90th percentile is $2,463.81 per claim, 9.6× the median.

Total Paid

$1.9M

0.00% of all spending

Total Claims

6K

Providers

12

Avg Cost/Claim

$338

National Cost Distribution

How much do providers bill per claim for 78812? Based on 12 providers billing this code nationally.

Median

$256.64

Average

$781.50

Std Dev

$1,349.60

Max

$4,386.63

Percentile Distribution (Cost per Claim)

p10
$33.01
p25
$45.41
Median
$256.64
p75
$564.67
p90
$2,463.81
p95
$3,433.97
p99
$4,196.10

50% of providers bill between $45.41 and $564.67 per claim for this code.

90% bill between $33.01 and $2,463.81.

Top 1% bill above $4,196.10.

About This Procedure

HCPCS code 78812 was billed by 12 providers across 6K claims, totaling $1.9M in Medicaid payments from 2018–2024. This code was used for 5K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$256.64

Providers Billing

12

National Spending

$1.9M

Avg/Median Ratio

3.05×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for 78812

#ProviderTotal Paid
1The General Hospital Corporation

Boston, MA · General Acute Care Hospital

$1.3M
21689772592$175K
31639278369$110K
41740283324$96K
51639172372$93K
61801874573$65K
71366495988$22K
81477624104$22K
91164493847$20K
101164512851$19K
111487730594$575
121154335487$70

Showing top 12 of 12 providers billing this code