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#4551 of 11K

M0239

HCPCS Procedure Code

HCPCS code M0239 is the #4,551 most-billed Medicaid procedure code, with $519K in payments across 5,117 claims from 2018–2024. The national median cost per claim is $98.17. Costs vary widely — the 90th percentile is $247.98 per claim, 2.5× the median.

Total Paid

$519K

0.00% of all spending

Total Claims

5,117

Providers

140

Avg Cost/Claim

$101

National Cost Distribution

How much do providers bill per claim for M0239? Based on 117 providers billing this code nationally.

Median

$98.17

Average

$119.27

Std Dev

$86.62

Max

$308.09

Percentile Distribution (Cost per Claim)

p10
$21.01
p25
$46.67
Median
$98.17
p75
$195.22
p90
$247.98
p95
$279.79
p99
$299.01

50% of providers bill between $46.67 and $195.22 per claim for this code.

90% bill between $21.01 and $247.98.

Top 1% bill above $299.01.

About This Procedure

HCPCS code M0239 was billed by 140 providers across 5,117 claims, totaling $519K in Medicaid payments from 2018–2024. This code was used for 4,424 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$98.17

Providers Billing

117

National Spending

$519K

Avg/Median Ratio

1.21×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for M0239

#ProviderTotal Paid
11457369381$25K
21922139120$22K
31366459570$20K
4Tucson Medical Center

Tucson, AZ · Clinic/Center, Hearing and Speech

$20K
5Yale New Haven Hospital

New Haven, CT · General Acute Care Hospital

$19K
6Reading Hospital

West Reading, PA · Surgery

$19K
71669470019$14K
8Medstar Washington Hospital Center

Washington, DC · General Acute Care Hospital

$13K
91407813660$13K
101841266194$12K
11Banner - University Medical Center Phoenix

Phoenix, AZ · Clinic/Center, Sleep Disorder Diagnostic

$12K
12Montefiore Medical Center

Bronx, NY · Anesthesiology

$12K
131184971038$11K
141043293608$10K
15Richmond Medical Center

Staten Island, NY · Psychiatric Unit

$10K
16Ochsner Clinic Foundation

New Orleans, LA · General Acute Care Hospital

$10K
17Rhode Island Hospital

Providence, RI · General Acute Care Hospital

$10K
18The Miriam Hospital

Providence, RI · General Acute Care Hospital

$10K
191194758284$9K
201972681484$9K

Showing top 20 of 140 providers billing this code