#3784 of 11K

26720

HCPCS Procedure Code

HCPCS code 26720 is the #3,784 most-billed Medicaid procedure code, with $1.2M in payments across 11K claims from 2018–2024. The national median cost per claim is $133.16. Costs vary widely — the 90th percentile is $341.30 per claim, 2.6× the median.

Total Paid

$1.2M

0.00% of all spending

Total Claims

11K

Providers

Avg Cost/Claim

$104

National Cost Distribution

How much do providers bill per claim for 26720? Based on 41 providers billing this code nationally.

Median

$133.16

Average

$163.28

Std Dev

$125.00

Max

$508.47

Percentile Distribution (Cost per Claim)

p10

$38.44

p25

$83.86

Median

$133.16

p75

$209.01

p90

$341.30

p95

$447.79

p99

$494.80

50% of providers bill between $83.86 and $209.01 per claim for this code.

90% bill between $38.44 and $341.30.

Top 1% bill above $494.80.

About This Procedure

HCPCS code 26720 was billed by 43 providers across 11K claims, totaling $1.2M in Medicaid payments from 2018–2024. This code was used for 9,341 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$133.16

Providers Billing

National Spending

$1.2M

Avg/Median Ratio

1.23×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 26720

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	Phoenix Children's Hospital Phoenix, AZ · General Acute Care Hospital Children	$215K	$357.93	2.7× median	Top 10%
2	Dayton Children's Hospital Dayton, OH · General Acute Care Hospital, Children	$185K	$474.30	3.6× median	Top 10%
3	1942300918	$168K	$38.84	0.3× median	Below Median
4	Ahava Medical And Rehabilitation Center, Llc Brooklyn, NY · Rehabilitation Practitioner	$107K	$447.79	3.4× median	Top 10%
5	The Cleveland Clinic Foundation Cleveland, OH · General Acute Care Hospital	$94K	$341.30	2.6× median	Above 75th
6	City Medical Of Upper East Side Pllc New York, NY · Clinic/Center Urgent Care	$64K	$74.30	0.6× median	Below Median
7	1073827101	$61K	$106.32	0.8× median	Below Median
8	The Metrohealth System Cleveland, OH · General Acute Care Hospital	$49K	$299.35	2.2× median	Above 75th
9	1083738637	$48K	$148.32	1.1× median	Above Median
10	1689632374	$32K	$26.48	0.2× median	Below Median
11	Phoenix Children's Hospital Phoenix, AZ · Pediatrics	$19K	$180.05	1.4× median	Above Median
12	1750351375	$17K	$87.60	0.7× median	Below Median
13	1508264938	$16K	$292.50	2.2× median	Above 75th
14	Unm Hospital Albuquerque, NM · General Acute Care Hospital	$8K	$148.51	1.1× median	Above Median
15	1437555265	$8K	$49.34	0.4× median	Below Median
16	1407865520	$8K	$238.87	1.8× median	Above 75th
17	1528017654	$7K	$229.04	1.7× median	Above 75th
18	Maimonides Medical Center Brooklyn, NY · General Acute Care Hospital	$6K	$508.47	3.8× median	Top 1%
19	1942754890	$6K	$209.01	1.6× median	Above Median
20	1093756025	$5K	$38.44	0.3× median	Below Median

Showing top 20 of 43 providers billing this code

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