#3623 of 11K

68801

HCPCS Procedure Code

HCPCS code 68801 is the #3,623 most-billed Medicaid procedure code, with $1.4M in payments across 35K claims from 2018–2024. The national median cost per claim is $49.95.

Total Paid

$1.4M

0.00% of all spending

Total Claims

35K

Providers

Avg Cost/Claim

$40

National Cost Distribution

How much do providers bill per claim for 68801? Based on 49 providers billing this code nationally.

Median

$49.95

Average

$49.54

Std Dev

$31.44

Max

$139.35

Percentile Distribution (Cost per Claim)

p10

$9.70

p25

$27.50

Median

$49.95

p75

$61.65

p90

$87.06

p95

$102.71

p99

$127.63

50% of providers bill between $27.50 and $61.65 per claim for this code.

90% bill between $9.70 and $87.06.

Top 1% bill above $127.63.

About This Procedure

HCPCS code 68801 was billed by 49 providers across 35K claims, totaling $1.4M in Medicaid payments from 2018–2024. This code was used for 27K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$49.95

Providers Billing

National Spending

$1.4M

Avg/Median Ratio

0.99×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 68801

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1083911929	$664K	$37.90	0.8× median	Below Median
2	1629486600	$127K	$60.40	1.2× median	Above Median
3	1093793143	$91K	$54.76	1.1× median	Above Median
4	1376018846	$60K	$102.50	2.1× median	Top 10%
5	1932582897	$53K	$56.70	1.1× median	Above Median
6	1396887428	$50K	$36.03	0.7× median	Below Median
7	1013453315	$46K	$84.06	1.7× median	Above 75th
8	1861983397	$42K	$78.62	1.6× median	Above 75th
9	1598274243	$29K	$46.55	0.9× median	Below Median
10	1487752168	$25K	$139.35	2.8× median	Top 1%
11	1174039531	$22K	$45.22	0.9× median	Below Median
12	1699117689	$21K	$61.65	1.2× median	Above 75th
13	1336313121	$19K	$102.85	2.1× median	Top 10%
14	1336319086	$18K	$11.72	0.2× median	Below Median
15	1326262817	$14K	$50.15	1.0× median	Above Median
16	1417031832	$13K	$10.12	0.2× median	Below Median
17	1497776108	$12K	$86.35	1.7× median	Above 75th
18	1982601191	$12K	$69.50	1.4× median	Above 75th
19	1417009168	$11K	$58.10	1.2× median	Above Median
20	1023435948	$10K	$25.84	0.5× median	Below Median

Showing top 20 of 49 providers billing this code

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