Statistical flags indicate unusual patterns — not proof of fraud or wrongdoing. Read our methodology

#2252 of 11K

C1894

HCPCS Procedure Code

HCPCS code C1894 is the #2,252 most-billed Medicaid procedure code, with $7.4M in payments across 758K claims from 2018–2024. The national median cost per claim is $5.06. Costs vary widely — the 90th percentile is $45.55 per claim, 9.0× the median.

Total Paid

$7.4M

0.00% of all spending

Total Claims

758K

Providers

825

Avg Cost/Claim

$10

National Cost Distribution

How much do providers bill per claim for C1894? Based on 548 providers billing this code nationally.

Median

$5.06

Average

$18.23

Std Dev

$47.70

Max

$833.92

Percentile Distribution (Cost per Claim)

p10
$0.04
p25
$0.52
Median
$5.06
p75
$18.69
p90
$45.55
p95
$69.65
p99
$155.81

50% of providers bill between $0.52 and $18.69 per claim for this code.

90% bill between $0.04 and $45.55.

Top 1% bill above $155.81.

About This Procedure

HCPCS code C1894 was billed by 825 providers across 758K claims, totaling $7.4M in Medicaid payments from 2018–2024. This code was used for 644K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$5.06

Providers Billing

548

National Spending

$7.4M

Avg/Median Ratio

3.60×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for C1894

#ProviderTotal Paid
1Nyu Langone Hospitals

New York, NY · Clinic/Center, Oncology

$513K
2University Of Kentucky

Lexington, KY · General Acute Care Hospital

$383K
3Charleston Area Medical Center Inc

Charleston, WV · General Acute Care Hospital

$296K
4Norton Hospitals Inc

Louisville, KY · General Acute Care Hospital

$286K
51629015698$257K
6Norton Hospitals, Inc

Louisville, KY · General Acute Care Hospital

$245K
7Montefiore Medical Center

Bronx, NY · General Acute Care Hospital

$216K
8Providence Health & Services Washington

Anchorage, AK · General Acute Care Hospital

$183K
91538244918$180K
101043293608$163K
111366459570$153K
121043220650$144K
13Unm Hospital

Albuquerque, NM · General Acute Care Hospital

$138K
14Rhode Island Hospital

Providence, RI · General Acute Care Hospital

$128K
151477616571$126K
16Owensboro Health Inc

Owensboro, KY · General Acute Care Hospital

$91K
171689282147$90K
181447231956$79K
19St. Mary's Medical Center Inc

Huntington, WV · General Acute Care Hospital

$77K
201265539498$77K

Showing top 20 of 825 providers billing this code