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#5063 of 11K

M0154

HCPCS Procedure Code

HCPCS code M0154 is the #5,063 most-billed Medicaid procedure code, with $303K in payments across 3,659 claims from 2018–2024. The national median cost per claim is $52.98.

Total Paid

$303K

0.00% of all spending

Total Claims

3,659

Providers

3

Avg Cost/Claim

$83

National Cost Distribution

How much do providers bill per claim for M0154? Based on 3 providers billing this code nationally.

Median

$52.98

Average

$53.27

Std Dev

$47.34

Max

$100.76

Percentile Distribution (Cost per Claim)

p10
$15.46
p25
$29.53
Median
$52.98
p75
$76.87
p90
$91.21
p95
$95.98
p99
$99.81

50% of providers bill between $29.53 and $76.87 per claim for this code.

90% bill between $15.46 and $91.21.

Top 1% bill above $99.81.

About This Procedure

HCPCS code M0154 was billed by 3 providers across 3,659 claims, totaling $303K in Medicaid payments from 2018–2024. This code was used for 864 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$52.98

Providers Billing

3

National Spending

$303K

Avg/Median Ratio

1.01×

Normal distribution

Provider Coverage

We have 3 providers billing this code in our dataset. Individual provider breakdowns are available for top-spending procedure codes.