#4489 of 11K

69610

HCPCS Procedure Code

HCPCS code 69610 is the #4,489 most-billed Medicaid procedure code, with $555K in payments across 1,651 claims from 2018–2024. The national median cost per claim is $461.79. Costs vary widely — the 90th percentile is $1,557.26 per claim, 3.4× the median.

Total Paid

$555K

0.00% of all spending

Total Claims

1,651

Providers

Avg Cost/Claim

$336

National Cost Distribution

How much do providers bill per claim for 69610? Based on 21 providers billing this code nationally.

Median

$461.79

Average

$793.58

Std Dev

$977.96

Max

$4,288.78

Percentile Distribution (Cost per Claim)

p10

$108.74

p25

$253.81

Median

$461.79

p75

$1,111.22

p90

$1,557.26

p95

$2,238.75

p99

$3,878.77

50% of providers bill between $253.81 and $1,111.22 per claim for this code.

90% bill between $108.74 and $1,557.26.

Top 1% bill above $3,878.77.

About This Procedure

HCPCS code 69610 was billed by 21 providers across 1,651 claims, totaling $555K in Medicaid payments from 2018–2024. This code was used for 1,527 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$461.79

Providers Billing

National Spending

$555K

Avg/Median Ratio

1.72×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for 69610

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	Scottish Rite Children's Medical Center Atlanta, GA · Pediatrics Pediatric Hematology-Oncology	$110K	$701.75	1.5× median	Above Median
2	Southern Baptist Hospital Of Florida Inc Jacksonville, FL · General Acute Care Hospital	$73K	$1,136.66	2.5× median	Above 75th
3	Upmc Children's Hospital Of Pittsburgh Pittsburgh, PA · Clinic/Center	$63K	$1,309.48	2.8× median	Above 75th
4	Southern Baptist Hospital Of Florida Inc Jacksonville, FL · General Acute Care Hospital Children	$51K	$4,288.78	9.3× median	Top 1%
5	Children's Hospital Medical Center Of Akron Akron, OH · General Acute Care Hospital Children	$39K	$1,111.22	2.4× median	Above 75th
6	1316219470	$38K	$494.11	1.1× median	Above Median
7	Childrens Hospital Of Philadelphia Philadelphia, PA · General Acute Care Hospital Children	$34K	$1,557.26	3.4× median	Top 10%
8	The Nemours Foundation Orlando, FL · General Acute Care Hospital Children	$34K	$2,238.75	4.8× median	Top 10%
9	1851400527	$15K	$19.30	0.0× median	Below Median
10	1679631360	$15K	$186.41	0.4× median	Below Median
11	1861886350	$14K	$504.55	1.1× median	Above Median
12	1861592867	$10K	$400.57	0.9× median	Below Median
13	1568420388	$9K	$108.74	0.2× median	Below Median
14	1811555014	$9K	$339.92	0.7× median	Below Median
15	Spectrum Health Hospitals Grand Rapids, MI · General Acute Care Hospital	$8K	$652.94	1.4× median	Above Median
16	1639285513	$7K	$253.81	0.5× median	Below Median
17	1437720414	$7K	$461.79	1.0× median	Below Median
18	1013913425	$6K	$393.21	0.9× median	Below Median
19	1235129883	$5K	$267.18	0.6× median	Below Median
20	1033133525	$4K	$183.64	0.4× median	Below Median

Showing top 20 of 21 providers billing this code

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