D0431
HCPCS Procedure Code
HCPCS code D0431 is the #5,859 most-billed Medicaid procedure code, with $128K in payments across 71K claims from 2018–2024. The national median cost per claim is $8.67. Costs vary widely — the 90th percentile is $31.45 per claim, 3.6× the median.
Total Paid
$128K
0.00% of all spending
Total Claims
71K
Providers
212
Avg Cost/Claim
$2
National Cost Distribution
How much do providers bill per claim for D0431? Based on 43 providers billing this code nationally.
Median
$8.67
Average
$12.00
Std Dev
$18.01
Max
$96.86
Percentile Distribution (Cost per Claim)
50% of providers bill between $1.18 and $9.93 per claim for this code.
90% bill between $0.19 and $31.45.
Top 1% bill above $77.13.
About This Procedure
HCPCS code D0431 was billed by 212 providers across 71K claims, totaling $128K in Medicaid payments from 2018–2024. This code was used for 66K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$8.67
Providers Billing
43
National Spending
$128K
Avg/Median Ratio
1.38×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for D0431
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1154498822 | $35K |
| 2 | 1124396874 | $29K |
| 3 | 1508477050 | $28K |
| 4 | 1730291493 | $6K |
| 5 | 1073925715 | $2K |
| 6 | 1497822209 | $2K |
| 7 | 1427376490 | $2K |
| 8 | 1285978288 | $2K |
| 9 | 1265722672 | $2K |
| 10 | 1972779445 | $2K |
| 11 | 1417108580 | $2K |
| 12 | 1407008154 | $2K |
| 13 | 1881007334 | $2K |
| 14 | 1669774022 | $2K |
| 15 | 1023274107 | $1K |
| 16 | 1356359046 | $986 |
| 17 | 1013309905 | $970 |
| 18 | 1003028036 | $970 |
| 19 | 1043715204 | $793 |
| 20 | 1003900887 | $735 |
Showing top 20 of 212 providers billing this code