#5345 of 11K

20930

HCPCS Procedure Code

HCPCS code 20930 is the #5,345 most-billed Medicaid procedure code, with $224K in payments across 4,185 claims from 2018–2024. The national median cost per claim is $74.48. Costs vary widely — the 90th percentile is $519.70 per claim, 7.0× the median.

Total Paid

$224K

0.00% of all spending

Total Claims

4,185

Providers

Avg Cost/Claim

$54

National Cost Distribution

How much do providers bill per claim for 20930? Based on 19 providers billing this code nationally.

Median

$74.48

Average

$145.83

Std Dev

$186.36

Max

$572.97

Percentile Distribution (Cost per Claim)

p10

$6.25

p25

$27.55

Median

$74.48

p75

$143.04

p90

$519.70

p95

$535.55

p99

$565.48

50% of providers bill between $27.55 and $143.04 per claim for this code.

90% bill between $6.25 and $519.70.

Top 1% bill above $565.48.

About This Procedure

HCPCS code 20930 was billed by 40 providers across 4,185 claims, totaling $224K in Medicaid payments from 2018–2024. This code was used for 3,004 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$74.48

Providers Billing

National Spending

$224K

Avg/Median Ratio

1.96×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for 20930

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	Norton Hospitals Inc Louisville, KY · General Acute Care Hospital	$121K	$516.77	6.9× median	Above 75th
2	Ohiohealth Corporation Columbus, OH · General Acute Care Hospital	$28K	$531.40	7.1× median	Top 10%
3	Norton Hospitals, Inc Louisville, KY · General Acute Care Hospital	$25K	$572.97	7.7× median	Top 1%
4	Lsu Health Sciences Center Shreveport Faculty Group Practice Shreveport, LA · Oral & Maxillofacial Surgery	$11K	$20.53	0.3× median	Below Median
5	1043279599	$7K	$255.82	3.4× median	Above 75th
6	1477582526	$6K	$43.36	0.6× median	Below Median
7	1841278496	$5K	$32.66	0.4× median	Below Median
8	1013303213	$3K	$37.56	0.5× median	Below Median
9	Community Medical Associates, Inc. Louisville, KY · Clinical Neuropsychologist	$3K	$74.48	1.0× median	Below Median
10	1578513016	$3K	$139.36	1.9× median	Above Median
11	1932264439	$3K	$22.45	0.3× median	Below Median
12	1396792412	$2K	$72.89	1.0× median	Below Median
13	1326091448	$2K	$115.29	1.5× median	Above Median
14	1740710250	$2K	$92.69	1.2× median	Above Median
15	1477624104	$2K	$146.71	2.0× median	Above 75th
16	1639376585	$1K	$84.00	1.1× median	Above Median
17	1396282356	$98	$1.27	0.0× median	Below Median
18	1760007330	$91	$3.79	0.1× median	Below Median
19	1952912420	$82	$6.87	0.1× median	Below Median
20	Carilion Medical Center Roanoke, VA · General Acute Care Hospital	$0	$0.00	0.0× median	Below Median

Showing top 20 of 40 providers billing this code

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