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

#1341 of 11K

H0007

HCPCS Procedure Code

HCPCS code H0007 is the #1,341 most-billed Medicaid procedure code, with $26.7M in payments across 102K claims from 2018–2024. The national median cost per claim is $71.08. Costs vary widely — the 90th percentile is $810.22 per claim, 11.4× the median.

Total Paid

$26.7M

0.00% of all spending

Total Claims

102K

Providers

52

Avg Cost/Claim

$262

National Cost Distribution

How much do providers bill per claim for H0007? Based on 49 providers billing this code nationally.

Median

$71.08

Average

$267.41

Std Dev

$339.68

Max

$1,185.53

Percentile Distribution (Cost per Claim)

p10
$21.51
p25
$45.02
Median
$71.08
p75
$475.38
p90
$810.22
p95
$914.33
p99
$1,180.92

50% of providers bill between $45.02 and $475.38 per claim for this code.

90% bill between $21.51 and $810.22.

Top 1% bill above $1,180.92.

About This Procedure

HCPCS code H0007 was billed by 52 providers across 102K claims, totaling $26.7M in Medicaid payments from 2018–2024. This code was used for 37K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$71.08

Providers Billing

49

National Spending

$26.7M

Avg/Median Ratio

3.76×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for H0007

#ProviderTotal Paid
11235782657$10.4M
2Alliance Healthcare Services

Memphis, TN · Community/Behavioral Health

$3.3M
31043886369$2.0M
41346466232$1.8M
51437273000$1.7M
61699392258$1.1M
71679514236$865K
81346500626$809K
91346207503$795K
101235347527$689K
11Kenaitze Indian Tribe

Kenai, AK · Community/Behavioral Health

$496K
121174171417$437K
131831502822$423K
141902439680$412K
151073841789$171K
161528062429$156K
17Providence Health & Services Washington

Anchorage, AK · General Acute Care Hospital

$144K
181720309693$137K
191548245871$109K
201154594216$85K

Showing top 20 of 52 providers billing this code