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#5035 of 11K

M0223

HCPCS Procedure Code

HCPCS code M0223 is the #5,035 most-billed Medicaid procedure code, with $313K in payments across 1,383 claims from 2018–2024. The national median cost per claim is $231.46.

Total Paid

$313K

0.00% of all spending

Total Claims

1,383

Providers

13

Avg Cost/Claim

$226

National Cost Distribution

How much do providers bill per claim for M0223? Based on 13 providers billing this code nationally.

Median

$231.46

Average

$245.52

Std Dev

$191.20

Max

$704.24

Percentile Distribution (Cost per Claim)

p10
$48.34
p25
$122.19
Median
$231.46
p75
$363.36
p90
$416.45
p95
$532.90
p99
$669.97

50% of providers bill between $122.19 and $363.36 per claim for this code.

90% bill between $48.34 and $416.45.

Top 1% bill above $669.97.

About This Procedure

HCPCS code M0223 was billed by 13 providers across 1,383 claims, totaling $313K in Medicaid payments from 2018–2024. This code was used for 1,088 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$231.46

Providers Billing

13

National Spending

$313K

Avg/Median Ratio

1.06×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for M0223

#ProviderTotal Paid
11588298053$71K
21487877593$59K
3Best Option Healthcare Puerto Rico Llc

San Juan, PR · Pharmacy Home Infusion Therapy Pharmacy

$57K
41932342276$56K
51952962169$21K
61922185248$19K
71356439905$8K
81598257503$6K
91356389845$6K
101871955807$6K
111407838766$3K
121063525210$1K
13The General Hospital Corporation

Boston, MA · General Acute Care Hospital

$551

Showing top 13 of 13 providers billing this code