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#8972 of 11K

M1016

HCPCS Procedure Code

HCPCS code M1016 is the #8,972 most-billed Medicaid procedure code, with $645 in payments across 28K claims from 2018–2024. The national median cost per claim is $0.03. Costs vary widely — the 90th percentile is $0.52 per claim, 17.3× the median.

Total Paid

$645

0.00% of all spending

Total Claims

28K

Providers

21

Avg Cost/Claim

$0

National Cost Distribution

How much do providers bill per claim for M1016? Based on 3 providers billing this code nationally.

Median

$0.03

Average

$0.23

Std Dev

$0.36

Max

$0.65

Percentile Distribution (Cost per Claim)

p10
$0.01
p25
$0.01
Median
$0.03
p75
$0.34
p90
$0.52
p95
$0.58
p99
$0.63

50% of providers bill between $0.01 and $0.34 per claim for this code.

90% bill between $0.01 and $0.52.

Top 1% bill above $0.63.

About This Procedure

HCPCS code M1016 was billed by 21 providers across 28K claims, totaling $645 in Medicaid payments from 2018–2024. This code was used for 22K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$0.03

Providers Billing

3

National Spending

$645

Avg/Median Ratio

7.67×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for M1016

#ProviderTotal Paid
11265051882$397
21932169240$248
31457744476$0
41780676650$0
51437245412$0
61497203541$0
71578021903$0
81396067500$0
91154736429$0
101710979588$0
111639599301$0
121053437509$0
131851300123$0
141598122871$0
151336185164$0
161013353481$0
171093904914$0
181649662719$0
191649363375$0
201912312273$0

Showing top 20 of 21 providers billing this code