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#3866 of 11K

W0137

HCPCS Procedure Code

HCPCS code W0137 is the #3,866 most-billed Medicaid procedure code, with $1.1M in payments across 30K claims from 2018–2024. The national median cost per claim is $49.64. Costs vary widely — the 90th percentile is $210.72 per claim, 4.2× the median.

Total Paid

$1.1M

0.00% of all spending

Total Claims

30K

Providers

16

Avg Cost/Claim

$35

National Cost Distribution

How much do providers bill per claim for W0137? Based on 15 providers billing this code nationally.

Median

$49.64

Average

$118.03

Std Dev

$150.65

Max

$591.06

Percentile Distribution (Cost per Claim)

p10
$24.33
p25
$26.65
Median
$49.64
p75
$187.95
p90
$210.72
p95
$325.95
p99
$538.04

50% of providers bill between $26.65 and $187.95 per claim for this code.

90% bill between $24.33 and $210.72.

Top 1% bill above $538.04.

About This Procedure

HCPCS code W0137 was billed by 16 providers across 30K claims, totaling $1.1M in Medicaid payments from 2018–2024. This code was used for 29K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$49.64

Providers Billing

15

National Spending

$1.1M

Avg/Median Ratio

2.38×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for W0137

#ProviderTotal Paid
11972693968$279K
21730207861$165K
31427123595$130K
4Medcare Equipment Company, Llc

Export, PA · Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies

$92K
51205837879$88K
6Home Care Delivered, Inc.

Richmond, VA · Durable Medical Equipment & Medical Supplies

$71K
71568417558$67K
81043215106$61K
91972558898$45K
101598766396$40K
111306025655$12K
121922071034$9K
131487723433$6K
141346322997$4K
151285671081$2K
161528168077$0

Showing top 16 of 16 providers billing this code

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