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#3969 of 11K

X0616

HCPCS Procedure Code

HCPCS code X0616 is the #3,969 most-billed Medicaid procedure code, with $971K in payments across 4,892 claims from 2018–2024. The national median cost per claim is $182.02.

Total Paid

$971K

0.00% of all spending

Total Claims

4,892

Providers

14

Avg Cost/Claim

$198

National Cost Distribution

How much do providers bill per claim for X0616? Based on 14 providers billing this code nationally.

Median

$182.02

Average

$189.34

Std Dev

$23.91

Max

$254.95

Percentile Distribution (Cost per Claim)

p10
$173.61
p25
$176.81
Median
$182.02
p75
$200.12
p90
$208.84
p95
$225.20
p99
$249.00

50% of providers bill between $176.81 and $200.12 per claim for this code.

90% bill between $173.61 and $208.84.

Top 1% bill above $249.00.

About This Procedure

HCPCS code X0616 was billed by 14 providers across 4,892 claims, totaling $971K in Medicaid payments from 2018–2024. This code was used for 4,816 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$182.02

Providers Billing

14

National Spending

$971K

Avg/Median Ratio

1.04×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for X0616

#ProviderTotal Paid
11356334510$264K
21942276423$200K
31396194197$120K
41235215427$97K
51548293954$76K
61013933175$59K
71497050470$42K
81922860360$32K
9Upmc Presbyterian Shadyside

Pittsburgh, PA · Clinic/Center

$31K
101952399933$25K
111073047981$13K
121275620585$7K
131316692585$3K
141457650343$2K

Showing top 14 of 14 providers billing this code