#2174 of 11K

W0037

HCPCS Procedure Code

HCPCS code W0037 is the #2,174 most-billed Medicaid procedure code, with $8.2M in payments across 449K claims from 2018–2024. The national median cost per claim is $3.00. Costs vary widely — the 90th percentile is $35.16 per claim, 11.7× the median.

Total Paid

$8.2M

0.00% of all spending

Total Claims

449K

Providers

177

Avg Cost/Claim

$18

National Cost Distribution

How much do providers bill per claim for W0037? Based on 177 providers billing this code nationally.

Median

$3.00

Average

$13.83

Std Dev

$18.76

Max

$84.05

Percentile Distribution (Cost per Claim)

p10

$3.00

p25

$3.00

Median

$3.00

p75

$18.12

p90

$35.16

p95

$65.58

p99

$77.74

50% of providers bill between $3.00 and $18.12 per claim for this code.

90% bill between $3.00 and $35.16.

Top 1% bill above $77.74.

About This Procedure

HCPCS code W0037 was billed by 177 providers across 449K claims, totaling $8.2M in Medicaid payments from 2018–2024. This code was used for 449K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$3.00

Providers Billing

177

National Spending

$8.2M

Avg/Median Ratio

4.61×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for W0037

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1093090342	$975K	$14.37	4.8× median	Above Median
2	Pine Ridge Indian Health Service Hospital Pine Ridge, SD · General Acute Care Hospital	$719K	$28.61	9.5× median	Above 75th
3	Rosebud Indian Health Service Rosebud, SD · General Acute Care Hospital	$315K	$30.65	10.2× median	Above 75th
4	1083779821	$271K	$33.84	11.3× median	Above 75th
5	Great Plains Tribal Chairmen's Health Board Rapid City, SD · Clinic/Center, Urgent Care	$267K	$20.84	6.9× median	Above 75th
6	1669508677	$230K	$14.73	4.9× median	Above Median
7	Pine Ridge Indian Health Service Hospital Kyle, SD · Clinic/Center	$223K	$31.83	10.6× median	Above 75th
8	1932295888	$206K	$25.87	8.6× median	Above 75th
9	1366471666	$205K	$44.81	14.9× median	Top 10%
10	1114002573	$194K	$62.36	20.8× median	Top 10%
11	1558395848	$190K	$24.33	8.1× median	Above 75th
12	1669027678	$190K	$24.79	8.3× median	Above 75th
13	1376575514	$190K	$7.06	2.4× median	Above Median
14	1215918339	$185K	$80.32	26.8× median	Top 1%
15	1821477746	$173K	$33.15	11.1× median	Above 75th
16	1639423957	$170K	$18.10	6.0× median	Above Median
17	1801840632	$170K	$68.75	22.9× median	Top 10%
18	1487602843	$157K	$28.66	9.6× median	Above 75th
19	1578942496	$144K	$37.16	12.4× median	Top 10%
20	1275553463	$142K	$16.01	5.3× median	Above Median

Showing top 20 of 177 providers billing this code

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