#3135 of 11K

L0174

HCPCS Procedure Code

HCPCS code L0174 is the #3,135 most-billed Medicaid procedure code, with $2.4M in payments across 19K claims from 2018–2024. The national median cost per claim is $119.20.

Total Paid

$2.4M

0.00% of all spending

Total Claims

19K

Providers

Avg Cost/Claim

$131

National Cost Distribution

How much do providers bill per claim for L0174? Based on 39 providers billing this code nationally.

Median

$119.20

Average

$129.27

Std Dev

$82.25

Max

$416.82

Percentile Distribution (Cost per Claim)

p10

$35.61

p25

$86.87

Median

$119.20

p75

$152.50

p90

$222.86

p95

$244.04

p99

$392.96

50% of providers bill between $86.87 and $152.50 per claim for this code.

90% bill between $35.61 and $222.86.

Top 1% bill above $392.96.

About This Procedure

HCPCS code L0174 was billed by 39 providers across 19K claims, totaling $2.4M in Medicaid payments from 2018–2024. This code was used for 17K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$119.20

Providers Billing

National Spending

$2.4M

Avg/Median Ratio

1.08×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for L0174

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1669417531	$327K	$128.74	1.1× median	Above Median
2	1326048893	$294K	$149.28	1.3× median	Above Median
3	1427179753	$264K	$154.75	1.3× median	Above 75th
4	1770096372	$182K	$129.21	1.1× median	Above Median
5	1891787594	$164K	$104.50	0.9× median	Below Median
6	1396821583	$161K	$99.79	0.8× median	Below Median
7	1043251341	$158K	$89.64	0.8× median	Below Median
8	Djo, Llc Carlsbad, CA · Prosthetic/Orthotic Supplier	$149K	$112.51	0.9× median	Below Median
9	1174573307	$147K	$222.34	1.9× median	Above 75th
10	1164535902	$132K	$138.73	1.2× median	Above Median
11	1093819419	$118K	$354.02	3.0× median	Top 10%
12	1467826263	$87K	$224.96	1.9× median	Top 10%
13	1821090390	$59K	$146.81	1.2× median	Above Median
14	1871038034	$33K	$84.10	0.7× median	Below Median
15	1841291200	$29K	$59.76	0.5× median	Below Median
16	1023079183	$26K	$231.82	1.9× median	Top 10%
17	1245237643	$10K	$106.30	0.9× median	Below Median
18	1275921660	$9K	$150.24	1.3× median	Above Median
19	1275784001	$9K	$117.46	1.0× median	Below Median
20	1386736841	$8K	$130.95	1.1× median	Above Median

Showing top 20 of 39 providers billing this code

Related Procedures

L0180$1.7M L0172$1.1M L0170$8K

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