K0816
HCPCS Procedure Code
HCPCS code K0816 is the #4,158 most-billed Medicaid procedure code, with $798K in payments across 18K claims from 2018–2024. The national median cost per claim is $39.22. Costs vary widely — the 90th percentile is $117.74 per claim, 3.0× the median.
Total Paid
$798K
0.00% of all spending
Total Claims
18K
Providers
21
Avg Cost/Claim
$45
National Cost Distribution
How much do providers bill per claim for K0816? Based on 20 providers billing this code nationally.
Median
$39.22
Average
$53.78
Std Dev
$43.42
Max
$179.63
Percentile Distribution (Cost per Claim)
50% of providers bill between $31.39 and $56.45 per claim for this code.
90% bill between $18.17 and $117.74.
Top 1% bill above $171.12.
About This Procedure
HCPCS code K0816 was billed by 21 providers across 18K claims, totaling $798K in Medicaid payments from 2018–2024. This code was used for 15K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$39.22
Providers Billing
20
National Spending
$798K
Avg/Median Ratio
1.37×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for K0816
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1588603492 | $164K |
| 2 | 1265602296 | $125K |
| 3 | 1184653024 | $119K |
| 4 | 1538373998 | $100K |
| 5 | 1023017647 | $71K |
| 6 | 1992759153 | $58K |
| 7 | 1366410177 | $32K |
| 8 | 1538137195 | $29K |
| 9 | 1891725115 | $25K |
| 10 | 1356450282 | $21K |
| 11 | 1962438465 | $18K |
| 12 | 1770738007 | $15K |
| 13 | 1730182023 | $5K |
| 14 | 1710985718 | $4K |
| 15 | 1851320774 | $3K |
| 16 | 1245569987 | $3K |
| 17 | 1427383728 | $3K |
| 18 | 1437502838 | $1K |
| 19 | 1831202159 | $882 |
| 20 | 1154891398 | $35 |
Showing top 20 of 21 providers billing this code