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#5557 of 11K

0969

HCPCS Procedure Code

HCPCS code 0969 is the #5,557 most-billed Medicaid procedure code, with $176K in payments across 2,532 claims from 2018–2024. The national median cost per claim is $73.78.

Total Paid

$176K

0.00% of all spending

Total Claims

2,532

Providers

14

Avg Cost/Claim

$70

National Cost Distribution

How much do providers bill per claim for 0969? Based on 14 providers billing this code nationally.

Median

$73.78

Average

$72.61

Std Dev

$8.14

Max

$85.47

Percentile Distribution (Cost per Claim)

p10
$62.42
p25
$69.82
Median
$73.78
p75
$76.32
p90
$81.43
p95
$83.62
p99
$85.10

50% of providers bill between $69.82 and $76.32 per claim for this code.

90% bill between $62.42 and $81.43.

Top 1% bill above $85.10.

About This Procedure

HCPCS code 0969 was billed by 14 providers across 2,532 claims, totaling $176K in Medicaid payments from 2018–2024. This code was used for 1,498 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$73.78

Providers Billing

14

National Spending

$176K

Avg/Median Ratio

0.98×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 0969

#ProviderTotal Paid
11952542896$46K
21669738159$26K
31386886117$25K
41538300488$17K
5County Of Ventura

Ventura, CA · Clinic/Center, Emergency Care

$14K
61316188253$11K
71841431707$8K
81932340890$7K
91174764021$7K
101134360076$6K
111982846366$3K
121548401409$2K
131780821660$1K
141861633703$1K

Showing top 14 of 14 providers billing this code

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