#3257 of 11K

36573

HCPCS Procedure Code

HCPCS code 36573 is the #3,257 most-billed Medicaid procedure code, with $2.1M in payments across 24K claims from 2018–2024. The national median cost per claim is $46.55. Costs vary widely — the 90th percentile is $193.56 per claim, 4.2× the median.

Total Paid

$2.1M

0.00% of all spending

Total Claims

24K

Providers

125

Avg Cost/Claim

$90

National Cost Distribution

How much do providers bill per claim for 36573? Based on 124 providers billing this code nationally.

Median

$46.55

Average

$99.98

Std Dev

$148.27

Max

$1,270.50

Percentile Distribution (Cost per Claim)

p10

$20.82

p25

$33.51

Median

$46.55

p75

$113.60

p90

$193.56

p95

$348.67

p99

$575.61

50% of providers bill between $33.51 and $113.60 per claim for this code.

90% bill between $20.82 and $193.56.

Top 1% bill above $575.61.

About This Procedure

HCPCS code 36573 was billed by 125 providers across 24K claims, totaling $2.1M in Medicaid payments from 2018–2024. This code was used for 21K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$46.55

Providers Billing

124

National Spending

$2.1M

Avg/Median Ratio

2.15×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for 36573

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1861475352	$347K	$178.17	3.8× median	Above 75th
2	1316957913	$142K	$346.61	7.4× median	Top 10%
3	Nationwide Children's Hospital Columbus, OH · General Acute Care Hospital	$141K	$462.53	9.9× median	Top 10%
4	1982023503	$136K	$246.44	5.3× median	Top 10%
5	1245390855	$95K	$54.25	1.2× median	Above Median
6	1295178689	$91K	$145.77	3.1× median	Above 75th
7	1760627764	$89K	$52.30	1.1× median	Above Median
8	1720561186	$83K	$122.87	2.6× median	Above 75th
9	1225033020	$68K	$97.68	2.1× median	Above Median
10	1457339277	$66K	$55.15	1.2× median	Above Median
11	1467678391	$56K	$96.24	2.1× median	Above Median
12	William Beaumont Hospital Royal Oak, MI · Internal Medicine, Cardiovascular Disease	$53K	$46.30	1.0× median	Below Median
13	1265475230	$49K	$143.28	3.1× median	Above 75th
14	1154367803	$48K	$46.04	1.0× median	Below Median
15	1487608931	$45K	$185.47	4.0× median	Above 75th
16	1659347771	$33K	$148.85	3.2× median	Above 75th
17	1467567511	$32K	$70.80	1.5× median	Above Median
18	1306864343	$28K	$81.59	1.8× median	Above Median
19	1831248236	$26K	$113.33	2.4× median	Above Median
20	1093772527	$22K	$118.56	2.5× median	Above 75th

Showing top 20 of 125 providers billing this code

Related Procedures

36581$1.2M 36569$1.1M 36572$330K 36568$66K 36575$19K

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