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#5224 of 11K

K0801

HCPCS Procedure Code

HCPCS code K0801 is the #5,224 most-billed Medicaid procedure code, with $257K in payments across 2,306 claims from 2018–2024. The national median cost per claim is $378.76. Costs vary widely — the 90th percentile is $1,648.94 per claim, 4.4× the median.

Total Paid

$257K

0.00% of all spending

Total Claims

2,306

Providers

7

Avg Cost/Claim

$112

National Cost Distribution

How much do providers bill per claim for K0801? Based on 7 providers billing this code nationally.

Median

$378.76

Average

$670.80

Std Dev

$719.31

Max

$1,739.34

Percentile Distribution (Cost per Claim)

p10
$77.37
p25
$94.20
Median
$378.76
p75
$1,161.53
p90
$1,648.94
p95
$1,694.14
p99
$1,730.30

50% of providers bill between $94.20 and $1,161.53 per claim for this code.

90% bill between $77.37 and $1,648.94.

Top 1% bill above $1,730.30.

About This Procedure

HCPCS code K0801 was billed by 7 providers across 2,306 claims, totaling $257K in Medicaid payments from 2018–2024. This code was used for 2,300 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$378.76

Providers Billing

7

National Spending

$257K

Avg/Median Ratio

1.77×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for K0801

#ProviderTotal Paid
1Med Star Surgical & Breathing Equipment Inc.

Bronx, NY · Prosthetic/Orthotic Supplier

$140K
21407894348$60K
31265405815$21K
41225001894$19K
51841263621$11K
61407245293$5K
71457396376$2K

Showing top 7 of 7 providers billing this code