20926
HCPCS Procedure Code
HCPCS code 20926 is the #5,890 most-billed Medicaid procedure code, with $123K in payments across 1,260 claims from 2018–2024. The national median cost per claim is $118.77. Costs vary widely — the 90th percentile is $286.12 per claim, 2.4× the median.
Total Paid
$123K
0.00% of all spending
Total Claims
1,260
Providers
6
Avg Cost/Claim
$98
National Cost Distribution
How much do providers bill per claim for 20926? Based on 6 providers billing this code nationally.
Median
$118.77
Average
$136.69
Std Dev
$134.68
Max
$337.22
Percentile Distribution (Cost per Claim)
50% of providers bill between $22.21 and $219.14 per claim for this code.
90% bill between $5.17 and $286.12.
Top 1% bill above $332.11.
About This Procedure
HCPCS code 20926 was billed by 6 providers across 1,260 claims, totaling $123K in Medicaid payments from 2018–2024. This code was used for 1,073 unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$118.77
Providers Billing
6
National Spending
$123K
Avg/Median Ratio
1.15×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for 20926
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1124339874 | $64K |
| 2 | 1740228469 | $42K |
| 3 | 1184824146 | $14K |
| 4 | Yale University New Haven, CT · Internal Medicine | $3K |
| 5 | 1346432481 | $153 |
| 6 | 1447274782 | $91 |
Showing top 6 of 6 providers billing this code