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#5040 of 11K

0296T

HCPCS Procedure Code

HCPCS code 0296T is the #5,040 most-billed Medicaid procedure code, with $311K in payments across 16K claims from 2018–2024. The national median cost per claim is $10.85. Costs vary widely — the 90th percentile is $55.13 per claim, 5.1× the median.

Total Paid

$311K

0.00% of all spending

Total Claims

16K

Providers

108

Avg Cost/Claim

$20

National Cost Distribution

How much do providers bill per claim for 0296T? Based on 102 providers billing this code nationally.

Median

$10.85

Average

$22.30

Std Dev

$32.76

Max

$209.46

Percentile Distribution (Cost per Claim)

p10
$1.07
p25
$4.40
Median
$10.85
p75
$26.19
p90
$55.13
p95
$79.62
p99
$166.89

50% of providers bill between $4.40 and $26.19 per claim for this code.

90% bill between $1.07 and $55.13.

Top 1% bill above $166.89.

About This Procedure

HCPCS code 0296T was billed by 108 providers across 16K claims, totaling $311K in Medicaid payments from 2018–2024. This code was used for 14K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$10.85

Providers Billing

102

National Spending

$311K

Avg/Median Ratio

2.06×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for 0296T

#ProviderTotal Paid
1Newark Beth Israel Medical Center Inc

Newark, NJ · General Acute Care Hospital

$45K
2University Of Kentucky

Lexington, KY · General Acute Care Hospital

$39K
31023331303$28K
4Montefiore Medical Center

Bronx, NY · General Acute Care Hospital

$27K
5The Queens Medical Center

Honolulu, HI · Psychiatric Unit

$22K
61336245828$20K
71063414258$13K
81770693939$9K
91467440743$9K
101306845557$7K
111881987675$7K
121487904546$5K
131538244918$5K
141679677983$5K
15The New York And Presbyterian Hospital

New York, NY · General Acute Care Hospital

$4K
16The General Hospital Corporation

Boston, MA · General Acute Care Hospital

$4K
17State Of Mississippi - University Of Mississippi Medical Center

Jackson, MS · General Acute Care Hospital

$4K
18Seventh-day Adventists Loma Linda University Medical Center

Loma Linda, CA · General Acute Care Hospital

$4K
191649220724$3K
201619914785$3K

Showing top 20 of 108 providers billing this code