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#5319 of 11K

15769

HCPCS Procedure Code

HCPCS code 15769 is the #5,319 most-billed Medicaid procedure code, with $230K in payments across 3,186 claims from 2018–2024. The national median cost per claim is $69.23. Costs vary widely — the 90th percentile is $587.57 per claim, 8.5× the median.

Total Paid

$230K

0.00% of all spending

Total Claims

3,186

Providers

6

Avg Cost/Claim

$72

National Cost Distribution

How much do providers bill per claim for 15769? Based on 6 providers billing this code nationally.

Median

$69.23

Average

$224.70

Std Dev

$350.04

Max

$914.20

Percentile Distribution (Cost per Claim)

p10
$17.29
p25
$36.66
Median
$69.23
p75
$218.66
p90
$587.57
p95
$750.88
p99
$881.54

50% of providers bill between $36.66 and $218.66 per claim for this code.

90% bill between $17.29 and $587.57.

Top 1% bill above $881.54.

About This Procedure

HCPCS code 15769 was billed by 6 providers across 3,186 claims, totaling $230K in Medicaid payments from 2018–2024. This code was used for 2,884 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$69.23

Providers Billing

6

National Spending

$230K

Avg/Median Ratio

3.25×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for 15769

#ProviderTotal Paid
11184824146$129K
21124339874$71K
31366570244$16K
41104933696$12K
51508121070$1K
61346432481$179

Showing top 6 of 6 providers billing this code

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