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#3201 of 11K

H0042

HCPCS Procedure Code

HCPCS code H0042 is the #3,201 most-billed Medicaid procedure code, with $2.2M in payments across 2,612 claims from 2018–2024. The national median cost per claim is $802.17.

Total Paid

$2.2M

0.00% of all spending

Total Claims

2,612

Providers

8

Avg Cost/Claim

$856

National Cost Distribution

How much do providers bill per claim for H0042? Based on 8 providers billing this code nationally.

Median

$802.17

Average

$873.12

Std Dev

$306.46

Max

$1,334.89

Percentile Distribution (Cost per Claim)

p10
$582.04
p25
$623.07
Median
$802.17
p75
$1,055.41
p90
$1,306.71
p95
$1,320.80
p99
$1,332.07

50% of providers bill between $623.07 and $1,055.41 per claim for this code.

90% bill between $582.04 and $1,306.71.

Top 1% bill above $1,332.07.

About This Procedure

HCPCS code H0042 was billed by 8 providers across 2,612 claims, totaling $2.2M in Medicaid payments from 2018–2024. This code was used for 2,546 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$802.17

Providers Billing

8

National Spending

$2.2M

Avg/Median Ratio

1.09×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for H0042

#ProviderTotal Paid
11578743878$705K
21477727345$580K
31427221837$503K
41255460978$230K
51548451826$93K
61114095395$49K
71144417346$43K
81689944720$33K

Showing top 8 of 8 providers billing this code