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#3840 of 11K

0097U

HCPCS Procedure Code

HCPCS code 0097U is the #3,840 most-billed Medicaid procedure code, with $1.1M in payments across 19K claims from 2018–2024. The national median cost per claim is $62.64. Costs vary widely — the 90th percentile is $204.77 per claim, 3.3× the median.

Total Paid

$1.1M

0.00% of all spending

Total Claims

19K

Providers

65

Avg Cost/Claim

$57

National Cost Distribution

How much do providers bill per claim for 0097U? Based on 54 providers billing this code nationally.

Median

$62.64

Average

$85.10

Std Dev

$82.19

Max

$350.55

Percentile Distribution (Cost per Claim)

p10
$2.06
p25
$12.04
Median
$62.64
p75
$130.87
p90
$204.77
p95
$233.95
p99
$298.18

50% of providers bill between $12.04 and $130.87 per claim for this code.

90% bill between $2.06 and $204.77.

Top 1% bill above $298.18.

About This Procedure

HCPCS code 0097U was billed by 65 providers across 19K claims, totaling $1.1M in Medicaid payments from 2018–2024. This code was used for 18K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$62.64

Providers Billing

54

National Spending

$1.1M

Avg/Median Ratio

1.36×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 0097U

#ProviderTotal Paid
1Laboratory Corporation Of America Holdings

Burlington, NC · Clinical Medical Laboratory

$401K
2Baptist Healthcare System Inc

Corbin, KY · General Acute Care Hospital

$147K
31730264128$68K
41710916945$62K
5Florida Clinical Practice Association Inc

Gainesville, FL · Surgery

$51K
61356307581$50K
71346297843$43K
81568452290$40K
91639135221$36K
101457389249$34K
111699874248$18K
12Medical University Hospital Authority

Charleston, SC · General Acute Care Hospital

$16K
131083249577$12K
14Bakersfield Memorial Hospital

Bakersfield, CA · General Acute Care Hospital

$11K
151639101199$9K
16Laboratory Corporation Of America

Phoenix, AZ · Clinical Medical Laboratory

$9K
171104829159$8K
181598748782$7K
19Laboratory Corporation Of America

Seattle, WA · Clinical Medical Laboratory

$7K
201538244918$7K

Showing top 20 of 65 providers billing this code