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#4846 of 11K

70260

HCPCS Procedure Code

HCPCS code 70260 is the #4,846 most-billed Medicaid procedure code, with $378K in payments across 19K claims from 2018–2024. The national median cost per claim is $12.54. Costs vary widely — the 90th percentile is $63.91 per claim, 5.1× the median.

Total Paid

$378K

0.00% of all spending

Total Claims

19K

Providers

61

Avg Cost/Claim

$20

National Cost Distribution

How much do providers bill per claim for 70260? Based on 59 providers billing this code nationally.

Median

$12.54

Average

$25.80

Std Dev

$36.20

Max

$176.62

Percentile Distribution (Cost per Claim)

p10
$3.18
p25
$8.37
Median
$12.54
p75
$22.78
p90
$63.91
p95
$111.23
p99
$160.09

50% of providers bill between $8.37 and $22.78 per claim for this code.

90% bill between $3.18 and $63.91.

Top 1% bill above $160.09.

About This Procedure

HCPCS code 70260 was billed by 61 providers across 19K claims, totaling $378K in Medicaid payments from 2018–2024. This code was used for 17K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$12.54

Providers Billing

59

National Spending

$378K

Avg/Median Ratio

2.06×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for 70260

#ProviderTotal Paid
11932208576$65K
2Variety Children's Hospital

Miami, FL · General Acute Care Hospital Children

$44K
31124022744$32K
41871582072$28K
51073684817$27K
61073827101$24K
7Norton Hospitals Inc

Louisville, KY · General Acute Care Hospital

$20K
8Vhs Childrens Hospital Of Michigan Inc

Detroit, MI · Clinic/Center, Ambulatory Surgical

$19K
91952452583$16K
101609192319$14K
111396731105$14K
12Norton Hospitals, Inc

Louisville, KY · General Acute Care Hospital

$12K
131700949336$6K
141548232044$6K
151700865094$5K
161336219849$5K
171780669200$4K
181780667923$4K
191437489754$3K
201750419974$2K

Showing top 20 of 61 providers billing this code

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