#3003 of 11K

M0245

HCPCS Procedure Code

HCPCS code M0245 is the #3,003 most-billed Medicaid procedure code, with $2.8M in payments across 12K claims from 2018–2024. The national median cost per claim is $246.46.

Total Paid

$2.8M

0.00% of all spending

Total Claims

12K

Providers

265

Avg Cost/Claim

$226

National Cost Distribution

How much do providers bill per claim for M0245? Based on 247 providers billing this code nationally.

Median

$246.46

Average

$243.58

Std Dev

$120.98

Max

$794.27

Percentile Distribution (Cost per Claim)

p10

$83.30

p25

$167.32

Median

$246.46

p75

$327.48

p90

$385.70

p95

$411.60

p99

$529.35

50% of providers bill between $167.32 and $327.48 per claim for this code.

90% bill between $83.30 and $385.70.

Top 1% bill above $529.35.

About This Procedure

HCPCS code M0245 was billed by 265 providers across 12K claims, totaling $2.8M in Medicaid payments from 2018–2024. This code was used for 11K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$246.46

Providers Billing

247

National Spending

$2.8M

Avg/Median Ratio

0.99×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for M0245

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	Henry Ford Health System Detroit, MI · General Acute Care Hospital	$82K	$240.60	1.0× median	Below Median
2	1124056296	$55K	$306.77	1.2× median	Above Median
3	Edward W Sparrow Hospital Association Lansing, MI · Rehabilitation, Substance Use Disorder Unit	$54K	$255.27	1.0× median	Above Median
4	Presbyterian Healthcare Services Albuquerque, NM · Emergency Medicine	$52K	$486.38	2.0× median	Top 10%
5	St Elizabeth Medical Center, Inc Edgewood, KY · Portable X-Ray and/or Other Portable Diagnostic Imaging Supplier	$46K	$348.72	1.4× median	Above 75th
6	1013286228	$46K	$399.68	1.6× median	Top 10%
7	1942275805	$44K	$365.39	1.5× median	Above 75th
8	1447207287	$44K	$288.10	1.2× median	Above Median
9	1366407603	$43K	$151.74	0.6× median	Below Median
10	1649209263	$41K	$249.80	1.0× median	Above Median
11	1598877268	$41K	$386.43	1.6× median	Top 10%
12	Charleston Area Medical Center Inc Charleston, WV · General Acute Care Hospital	$39K	$426.98	1.7× median	Top 10%
13	1043248743	$36K	$397.54	1.6× median	Top 10%
14	1023114634	$34K	$234.98	1.0× median	Below Median
15	The Hospital Of Central Connecticut At New Britain General And Bradley New Britain, CT · General Acute Care Hospital	$34K	$311.07	1.3× median	Above Median
16	1831132133	$33K	$224.83	0.9× median	Below Median
17	1902865355	$32K	$261.51	1.1× median	Above Median
18	1861479545	$32K	$326.57	1.3× median	Above Median
19	1811065626	$30K	$442.00	1.8× median	Top 10%
20	1841266194	$30K	$284.92	1.2× median	Above Median

Showing top 20 of 265 providers billing this code

Related Procedures

M0243$13.3M M0240$7.5M M0241$6.8M M0247$1.8M M0244$1.3M

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