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#1282 of 11K

W0016

HCPCS Procedure Code

HCPCS code W0016 is the #1,282 most-billed Medicaid procedure code, with $29.4M in payments across 415K claims from 2018–2024. The national median cost per claim is $72.46.

Total Paid

$29.4M

0.00% of all spending

Total Claims

415K

Providers

51

Avg Cost/Claim

$71

National Cost Distribution

How much do providers bill per claim for W0016? Based on 51 providers billing this code nationally.

Median

$72.46

Average

$74.02

Std Dev

$15.95

Max

$119.38

Percentile Distribution (Cost per Claim)

p10
$55.48
p25
$62.92
Median
$72.46
p75
$83.98
p90
$93.07
p95
$103.52
p99
$114.32

50% of providers bill between $62.92 and $83.98 per claim for this code.

90% bill between $55.48 and $93.07.

Top 1% bill above $114.32.

About This Procedure

HCPCS code W0016 was billed by 51 providers across 415K claims, totaling $29.4M in Medicaid payments from 2018–2024. This code was used for 213K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$72.46

Providers Billing

51

National Spending

$29.4M

Avg/Median Ratio

1.02×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for W0016

#ProviderTotal Paid
11407994684$6.8M
21275908378$2.3M
31154463800$2.1M
41346209962$1.9M
51629005764$1.5M
6Service Access And Management Inc

Reading, PA · Community/Behavioral Health

$1.3M
71962513002$1.2M
81093851289$1.1M
91205956059$990K
101457482606$897K
111407978174$689K
121114047966$670K
131639206162$582K
141639202534$532K
151679796155$506K
161497749709$499K
171962550590$409K
181558714022$386K
191114060159$351K
201427273911$349K

Showing top 20 of 51 providers billing this code

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