#1536 of 11K

10061

HCPCS Procedure Code

HCPCS code 10061 is the #1,536 most-billed Medicaid procedure code, with $19.9M in payments across 179K claims from 2018–2024. The national median cost per claim is $101.03. Costs vary widely — the 90th percentile is $209.41 per claim, 2.1× the median.

Total Paid

$19.9M

0.00% of all spending

Total Claims

179K

Providers

388

Avg Cost/Claim

$111

National Cost Distribution

How much do providers bill per claim for 10061? Based on 375 providers billing this code nationally.

Median

$101.03

Average

$116.48

Std Dev

$93.34

Max

$1,045.88

Percentile Distribution (Cost per Claim)

p10

$19.87

p25

$56.51

Median

$101.03

p75

$157.78

p90

$209.41

p95

$265.13

p99

$348.49

50% of providers bill between $56.51 and $157.78 per claim for this code.

90% bill between $19.87 and $209.41.

Top 1% bill above $348.49.

About This Procedure

HCPCS code 10061 was billed by 388 providers across 179K claims, totaling $19.9M in Medicaid payments from 2018–2024. This code was used for 147K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$101.03

Providers Billing

375

National Spending

$19.9M

Avg/Median Ratio

1.15×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 10061

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1023104023	$2.2M	$190.00	1.9× median	Above 75th
2	1215096375	$1.2M	$224.34	2.2× median	Top 10%
3	1093068611	$823K	$129.02	1.3× median	Above Median
4	1164408282	$695K	$155.87	1.5× median	Above Median
5	1285231506	$580K	$223.61	2.2× median	Top 10%
6	1821285974	$464K	$106.18	1.1× median	Above Median
7	1275714990	$421K	$25.31	0.3× median	Below Median
8	1013994839	$360K	$110.87	1.1× median	Above Median
9	Yale New Haven Hospital New Haven, CT · General Acute Care Hospital	$310K	$276.46	2.7× median	Top 10%
10	Saint Francis Hospital And Medical Center Hartford, CT · General Acute Care Hospital	$307K	$291.19	2.9× median	Top 10%
11	1487654596	$295K	$188.18	1.9× median	Above 75th
12	1083708655	$293K	$168.84	1.7× median	Above 75th
13	Swedish Health Services Seattle, WA · General Acute Care Hospital	$275K	$180.13	1.8× median	Above 75th
14	The Hospital Of Central Connecticut At New Britain General And Bradley New Britain, CT · General Acute Care Hospital	$265K	$308.08	3.0× median	Top 10%
15	1225289895	$226K	$204.12	2.0× median	Above 75th
16	1295944171	$225K	$100.28	1.0× median	Below Median
17	1265976971	$193K	$95.06	0.9× median	Below Median
18	Public Hospital District 1 Of King County Renton, WA · General Acute Care Hospital	$191K	$215.24	2.1× median	Top 10%
19	1992281000	$188K	$88.62	0.9× median	Below Median
20	City Medical Of Upper East Side Pllc New York, NY · Clinic/Center Urgent Care	$188K	$87.55	0.9× median	Below Median

Showing top 20 of 388 providers billing this code

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