#4219 of 11K

70549

HCPCS Procedure Code

HCPCS code 70549 is the #4,219 most-billed Medicaid procedure code, with $745K in payments across 4,751 claims from 2018–2024. The national median cost per claim is $106.05. Costs vary widely — the 90th percentile is $242.79 per claim, 2.3× the median.

Total Paid

$745K

0.00% of all spending

Total Claims

4,751

Providers

Avg Cost/Claim

$157

National Cost Distribution

How much do providers bill per claim for 70549? Based on 26 providers billing this code nationally.

Median

$106.05

Average

$195.98

Std Dev

$340.77

Max

$1,807.38

Percentile Distribution (Cost per Claim)

p10

$45.02

p25

$53.39

Median

$106.05

p75

$205.99

p90

$242.79

p95

$356.37

p99

$1,453.86

50% of providers bill between $53.39 and $205.99 per claim for this code.

90% bill between $45.02 and $242.79.

Top 1% bill above $1,453.86.

About This Procedure

HCPCS code 70549 was billed by 26 providers across 4,751 claims, totaling $745K in Medicaid payments from 2018–2024. This code was used for 4,160 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$106.05

Providers Billing

National Spending

$745K

Avg/Median Ratio

1.85×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for 70549

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1972004489	$360K	$205.59	1.9× median	Above Median
2	Stanford Health Care Stanford, CA · General Acute Care Hospital	$144K	$393.28	3.7× median	Top 10%
3	1952307175	$63K	$47.06	0.4× median	Below Median
4	1518951300	$61K	$163.35	1.5× median	Above Median
5	1811951429	$25K	$1,807.38	17.0× median	Top 1%
6	1548393127	$22K	$245.61	2.3× median	Top 10%
7	1891925582	$14K	$191.63	1.8× median	Above Median
8	1336757699	$10K	$220.32	2.1× median	Above 75th
9	1740283324	$7K	$47.42	0.4× median	Below Median
10	1487730594	$6K	$55.54	0.5× median	Below Median
11	1578819850	$5K	$210.75	2.0× median	Above 75th
12	1477609865	$4K	$32.15	0.3× median	Below Median
13	Trustees Of The University Of Pennsylvania Philadelphia, PA · Community/Behavioral Health	$3K	$239.97	2.3× median	Above 75th
14	Inova Health Care Services Falls Church, VA · Clinic/Center, Rehabilitation, Substance Use Disorder	$3K	$165.10	1.6× median	Above Median
15	1194826115	$2K	$177.99	1.7× median	Above Median
16	1902865355	$2K	$206.12	1.9× median	Above 75th
17	1700861580	$2K	$50.94	0.5× median	Below Median
18	1114902509	$2K	$42.98	0.4× median	Below Median
19	1154367803	$2K	$61.22	0.6× median	Below Median
20	Aurora Health Care Metro, Inc. Milwaukee, WI · Internal Medicine, Hematology & Oncology	$1K	$110.39	1.0× median	Above Median

Showing top 20 of 26 providers billing this code

Related Procedures

70553MRI brain without contrast, then with contrast$675.4M 70551MRI brain without contrast$424.0M 70543$17.6M 70544$12.6M 70547$933K

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