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#7010 of 11K

M0198

HCPCS Procedure Code

HCPCS code M0198 is the #7,010 most-billed Medicaid procedure code, with $32K in payments across 103 claims from 2018–2024. The national median cost per claim is $278.33.

Total Paid

$32K

0.00% of all spending

Total Claims

103

Providers

3

Avg Cost/Claim

$310

National Cost Distribution

How much do providers bill per claim for M0198? Based on 3 providers billing this code nationally.

Median

$278.33

Average

$273.58

Std Dev

$63.80

Max

$334.87

Percentile Distribution (Cost per Claim)

p10
$221.69
p25
$242.93
Median
$278.33
p75
$306.60
p90
$323.56
p95
$329.22
p99
$333.74

50% of providers bill between $242.93 and $306.60 per claim for this code.

90% bill between $221.69 and $323.56.

Top 1% bill above $333.74.

About This Procedure

HCPCS code M0198 was billed by 3 providers across 103 claims, totaling $32K in Medicaid payments from 2018–2024. This code was used for 97 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$278.33

Providers Billing

3

National Spending

$32K

Avg/Median Ratio

0.98×

Normal distribution

Provider Coverage

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