69209
HCPCS Procedure Code
HCPCS code 69209 is the #3,701 most-billed Medicaid procedure code, with $1.3M in payments across 100K claims from 2018–2024. The national median cost per claim is $8.70. Costs vary widely — the 90th percentile is $41.94 per claim, 4.8× the median.
Total Paid
$1.3M
0.00% of all spending
Total Claims
100K
Providers
465
Avg Cost/Claim
$13
National Cost Distribution
How much do providers bill per claim for 69209? Based on 370 providers billing this code nationally.
Median
$8.70
Average
$20.57
Std Dev
$56.63
Max
$855.97
Percentile Distribution (Cost per Claim)
50% of providers bill between $4.43 and $13.18 per claim for this code.
90% bill between $0.87 and $41.94.
Top 1% bill above $154.23.
About This Procedure
HCPCS code 69209 was billed by 465 providers across 100K claims, totaling $1.3M in Medicaid payments from 2018–2024. This code was used for 90K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$8.70
Providers Billing
370
National Spending
$1.3M
Avg/Median Ratio
2.36×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for 69209
| # | Provider | Total Paid |
|---|---|---|
| 1 | Baystate Medical Center Inc Springfield, MA · General Acute Care Hospital | $98K |
| 2 | Unm Hospital Albuquerque, NM · General Acute Care Hospital | $96K |
| 3 | Medical University Hospital Authority Charleston, SC · General Acute Care Hospital | $77K |
| 4 | New York City Health And Hospitals Corporation Bronx, NY · Internal Medicine | $44K |
| 5 | 1841231461 | $41K |
| 6 | University Of Utah Salt Lake City, UT · Clinic/Center, Dental | $39K |
| 7 | Phoenix Children's Hospital Phoenix, AZ · General Acute Care Hospital Children | $37K |
| 8 | Group Health Plan, Inc. Minneapolis, MN · Clinic/Center, Multi-Specialty | $35K |
| 9 | 1588959084 | $34K |
| 10 | Mary Imogene Bassett Hospital Cooperstown, NY · General Acute Care Hospital, Rural | $34K |
| 11 | 1578058137 | $31K |
| 12 | Bexar County Hospital District San Antonio, TX · Clinical Medical Laboratory | $29K |
| 13 | Childrens Hospital Of The Kings Daughters Inc Norfolk, VA · Social Worker, Clinical | $29K |
| 14 | Park Nicollet Clinic St Louis Park, MN · Obstetrics & Gynecology | $29K |
| 15 | Medical Associates Of Ebnhc East Boston, MA · Clinic/Center, Community Health | $26K |
| 16 | Adventist Health System-sunbelt, Inc Orlando, FL · Ambulance, Land Transport | $21K |
| 17 | 1568688992 | $19K |
| 18 | The Cleveland Clinic Foundation Cleveland, OH · General Acute Care Hospital | $16K |
| 19 | Multicare Health System Tacoma, WA · Community/Behavioral Health | $16K |
| 20 | 1821422007 | $14K |
Showing top 20 of 465 providers billing this code