#1562 of 11K

D8030

HCPCS Procedure Code

HCPCS code D8030 is the #1,562 most-billed Medicaid procedure code, with $19.1M in payments across 200K claims from 2018–2024. The national median cost per claim is $86.77. Costs vary widely — the 90th percentile is $353.75 per claim, 4.1× the median.

Total Paid

$19.1M

0.00% of all spending

Total Claims

200K

Providers

126

Avg Cost/Claim

$95

National Cost Distribution

How much do providers bill per claim for D8030? Based on 124 providers billing this code nationally.

Median

$86.77

Average

$224.13

Std Dev

$251.43

Max

$1,531.66

Percentile Distribution (Cost per Claim)

p10

$73.61

p25

$80.11

Median

$86.77

p75

$321.89

p90

$353.75

p95

$487.64

p99

$1,433.33

50% of providers bill between $80.11 and $321.89 per claim for this code.

90% bill between $73.61 and $353.75.

Top 1% bill above $1,433.33.

About This Procedure

HCPCS code D8030 was billed by 126 providers across 200K claims, totaling $19.1M in Medicaid payments from 2018–2024. This code was used for 184K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$86.77

Providers Billing

124

National Spending

$19.1M

Avg/Median Ratio

2.58×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for D8030

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1588950661	$1.7M	$71.52	0.8× median	Below Median
2	1356498778	$837K	$75.58	0.9× median	Below Median
3	1104248293	$754K	$326.92	3.8× median	Above 75th
4	1255508651	$683K	$73.59	0.8× median	Below Median
5	1124261391	$589K	$81.50	0.9× median	Below Median
6	1184018616	$573K	$315.28	3.6× median	Above Median
7	1669645461	$559K	$44.90	0.5× median	Below Median
8	1326328600	$551K	$316.04	3.6× median	Above Median
9	1477569507	$536K	$77.20	0.9× median	Below Median
10	1285704437	$536K	$49.94	0.6× median	Below Median
11	1194873281	$467K	$75.84	0.9× median	Below Median
12	1699814566	$439K	$77.46	0.9× median	Below Median
13	1154549178	$433K	$81.78	0.9× median	Below Median
14	1851325062	$421K	$88.33	1.0× median	Above Median
15	1801212303	$419K	$75.96	0.9× median	Below Median
16	1023032687	$411K	$91.32	1.1× median	Above Median
17	1497930168	$363K	$79.84	0.9× median	Below Median
18	1568503605	$356K	$80.39	0.9× median	Below Median
19	Rock Dental Arkansas Pllc Hot Springs, AR · Dentist, Orthodontics and Dentofacial Orthopedics	$354K	$1,281.67	14.8× median	Top 10%
20	1871608380	$328K	$71.02	0.8× median	Below Median

Showing top 20 of 126 providers billing this code

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