01968
HCPCS Procedure Code
HCPCS code 01968 is the #3,419 most-billed Medicaid procedure code, with $1.7M in payments across 25K claims from 2018–2024. The national median cost per claim is $72.10. Costs vary widely — the 90th percentile is $207.87 per claim, 2.9× the median.
Total Paid
$1.7M
0.00% of all spending
Total Claims
25K
Providers
82
Avg Cost/Claim
$70
National Cost Distribution
How much do providers bill per claim for 01968? Based on 74 providers billing this code nationally.
Median
$72.10
Average
$102.01
Std Dev
$79.12
Max
$378.97
Percentile Distribution (Cost per Claim)
50% of providers bill between $43.21 and $131.92 per claim for this code.
90% bill between $35.76 and $207.87.
Top 1% bill above $349.61.
About This Procedure
HCPCS code 01968 was billed by 82 providers across 25K claims, totaling $1.7M in Medicaid payments from 2018–2024. This code was used for 20K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$72.10
Providers Billing
74
National Spending
$1.7M
Avg/Median Ratio
1.41×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for 01968
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1053354233 | $256K |
| 2 | 1871986372 | $182K |
| 3 | 1972126209 | $132K |
| 4 | 1225016926 | $130K |
| 5 | 1669581997 | $110K |
| 6 | 1417994872 | $94K |
| 7 | 1558314427 | $77K |
| 8 | 1942270566 | $52K |
| 9 | 1477068971 | $50K |
| 10 | 1053366377 | $49K |
| 11 | 1487609475 | $39K |
| 12 | 1710324041 | $39K |
| 13 | 1003989690 | $38K |
| 14 | 1558391763 | $38K |
| 15 | 1346267267 | $34K |
| 16 | 1407821796 | $33K |
| 17 | 1922031442 | $32K |
| 18 | 1740232768 | $32K |
| 19 | 1265836068 | $31K |
| 20 | William Beaumont Hospital Royal Oak, MI · Internal Medicine, Cardiovascular Disease | $24K |
Showing top 20 of 82 providers billing this code