#6336 of 11K

C1819

HCPCS Procedure Code

HCPCS code C1819 is the #6,336 most-billed Medicaid procedure code, with $73K in payments across 6,465 claims from 2018–2024. The national median cost per claim is $15.50. Costs vary widely — the 90th percentile is $167.46 per claim, 10.8× the median.

Total Paid

$73K

0.00% of all spending

Total Claims

6,465

Providers

Avg Cost/Claim

$11

National Cost Distribution

How much do providers bill per claim for C1819? Based on 17 providers billing this code nationally.

Median

$15.50

Average

$55.78

Std Dev

$72.82

Max

$234.48

Percentile Distribution (Cost per Claim)

p10

$0.47

p25

$1.41

Median

$15.50

p75

$64.07

p90

$167.46

p95

$185.80

p99

$224.75

50% of providers bill between $1.41 and $64.07 per claim for this code.

90% bill between $0.47 and $167.46.

Top 1% bill above $224.75.

About This Procedure

HCPCS code C1819 was billed by 29 providers across 6,465 claims, totaling $73K in Medicaid payments from 2018–2024. This code was used for 5,781 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$15.50

Providers Billing

National Spending

$73K

Avg/Median Ratio

3.60×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for C1819

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	The New York And Presbyterian Hospital New York, NY · General Acute Care Hospital	$24K	$56.91	3.7× median	Above Median
2	Newyork-presbyterian-queens Flushing, NY · General Acute Care Hospital	$21K	$49.42	3.2× median	Above Median
3	1104821305	$10K	$173.63	11.2× median	Top 10%
4	1235139312	$4K	$163.35	10.5× median	Above 75th
5	The New York And Presbyterian Hospital New York, NY · General Acute Care Hospital	$3K	$45.81	3.0× median	Above Median
6	1538244918	$3K	$234.48	15.1× median	Top 1%
7	St. Barnabas Hospital Bronx, NY · General Acute Care Hospital	$3K	$64.07	4.1× median	Above 75th
8	1407813603	$1K	$116.45	7.5× median	Above 75th
9	1205877172	$1K	$7.85	0.5× median	Below Median
10	1992789721	$836	$3.94	0.3× median	Below Median
11	Mount Sinai Hospital New York, NY · Ambulance	$635	$15.50	1.0× median	Below Median
12	Beth Israel Medical Center Brooklyn, NY · Psychiatric Unit	$570	$13.26	0.9× median	Below Median
13	University Of Washington Seattle, WA · Clinic/Center, Dental	$176	$0.42	0.0× median	Below Median
14	Virginia Commonwealth University Health System Authority Richmond, VA · General Acute Care Hospital	$87	$0.03	0.0× median	Below Median
15	1912909912	$51	$0.50	0.0× median	Below Median
16	1780633289	$40	$1.28	0.1× median	Below Median
17	1427536325	$38	$1.41	0.1× median	Below Median
18	The General Hospital Corporation Boston, MA · General Acute Care Hospital	$0	$0.00	0.0× median	Below Median
19	Medstar Washington Hospital Center Washington, DC · General Acute Care Hospital	$0	$0.00	0.0× median	Below Median
20	The Metrohealth System Cleveland, OH · General Acute Care Hospital	$0	$0.00	0.0× median	Below Median

Showing top 20 of 29 providers billing this code

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