36416
HCPCS Procedure Code
HCPCS code 36416 is the #1,370 most-billed Medicaid procedure code, with $25.5M in payments across 10.7M claims from 2018–2024. The national median cost per claim is $1.31. Costs vary widely — the 90th percentile is $4.41 per claim, 3.4× the median.
Total Paid
$25.5M
0.00% of all spending
Total Claims
10.7M
Providers
7K
Avg Cost/Claim
$2
National Cost Distribution
How much do providers bill per claim for 36416? Based on 5K providers billing this code nationally.
Median
$1.31
Average
$3.06
Std Dev
$11.73
Max
$429.43
Percentile Distribution (Cost per Claim)
50% of providers bill between $0.22 and $2.82 per claim for this code.
90% bill between $0.03 and $4.41.
Top 1% bill above $36.18.
About This Procedure
HCPCS code 36416 was billed by 7K providers across 10.7M claims, totaling $25.5M in Medicaid payments from 2018–2024. This code was used for 9.2M unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$1.31
Providers Billing
5K
National Spending
$25.5M
Avg/Median Ratio
2.34×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for 36416
| # | Provider | Total Paid |
|---|---|---|
| 1 | Long Island Jewish Medical Center New Hyde Park, NY · General Acute Care Hospital | $2.8M |
| 2 | University Of Utah Salt Lake City, UT · Clinic/Center, Dental | $1.7M |
| 3 | 1699756221 | $1.2M |
| 4 | Nationwide Children's Hospital Columbus, OH · General Acute Care Hospital | $678K |
| 5 | 1417959701 | $597K |
| 6 | Spartanburg Medical Center Spartanburg, SC · Ambulance | $512K |
| 7 | 1932199171 | $416K |
| 8 | 1609923671 | $399K |
| 9 | 1841224508 | $362K |
| 10 | 1407877137 | $274K |
| 11 | Mary Imogene Bassett Hospital Cooperstown, NY · General Acute Care Hospital, Rural | $261K |
| 12 | 1487868097 | $241K |
| 13 | 1578672846 | $210K |
| 14 | 1235196510 | $190K |
| 15 | Hennepin Healthcare System Inc Minneapolis, MN · General Acute Care Hospital | $187K |
| 16 | The New York And Presbyterian Hospital New York, NY · General Acute Care Hospital | $177K |
| 17 | 1326695255 | $167K |
| 18 | 1265892012 | $166K |
| 19 | The New York And Presbyterian Hospital New York, NY · General Acute Care Hospital | $163K |
| 20 | 1437197985 | $156K |
Showing top 20 of 7K providers billing this code