72197
HCPCS Procedure Code
HCPCS code 72197 is the #938 most-billed Medicaid procedure code, with $56.6M in payments across 188K claims from 2018–2024. The national median cost per claim is $201.67. Costs vary widely — the 90th percentile is $482.81 per claim, 2.4× the median.
Total Paid
$56.6M
0.01% of all spending
Total Claims
188K
Providers
487
Avg Cost/Claim
$300
National Cost Distribution
How much do providers bill per claim for 72197? Based on 483 providers billing this code nationally.
Median
$201.67
Average
$261.25
Std Dev
$247.82
Max
$2,058.30
Percentile Distribution (Cost per Claim)
50% of providers bill between $99.08 and $339.02 per claim for this code.
90% bill between $59.21 and $482.81.
Top 1% bill above $1,399.95.
About This Procedure
HCPCS code 72197 was billed by 487 providers across 188K claims, totaling $56.6M in Medicaid payments from 2018–2024. This code was used for 179K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$201.67
Providers Billing
483
National Spending
$56.6M
Avg/Median Ratio
1.30×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for 72197
| # | Provider | Total Paid |
|---|---|---|
| 1 | Scottish Rite Children's Medical Center Atlanta, GA · Pediatrics Pediatric Hematology-Oncology | $3.7M |
| 2 | Lenox Hill Radiology & Medical Imaging Associates, Pc New York, NY · Radiology, Body Imaging | $3.5M |
| 3 | Beverly Radiology Medical Group Iii Los Angeles, CA · Radiology, Diagnostic Radiology | $2.3M |
| 4 | Yale New Haven Hospital New Haven, CT · General Acute Care Hospital | $1.9M |
| 5 | University Of Kentucky Lexington, KY · General Acute Care Hospital | $1.8M |
| 6 | Regents Of The University Of California San Diego, CA · General Acute Care Hospital | $1.4M |
| 7 | Stanford Health Care Stanford, CA · General Acute Care Hospital | $1.4M |
| 8 | 1366459570 | $1.2M |
| 9 | New York Network Ipa Inc Brooklyn, NY · Exclusive Provider Organization | $1.1M |
| 10 | Regents Of The University Of Michigan Ann Arbor, MI · Clinic/Center, End-Stage Renal Disease (ESRD) Treatment | $979K |
| 11 | The New York And Presbyterian Hospital New York, NY · General Acute Care Hospital | $944K |
| 12 | Egleston Children's Hospital At Emory University Inc. Atlanta, GA · Pediatrics Pediatric Emergency Medicine | $887K |
| 13 | Beth Israel Deaconess Medical Center, Inc. Boston, MA · General Acute Care Hospital | $878K |
| 14 | Banner - University Medical Center Tucson Campus Llc Tucson, AZ · Clinic/Center, Multi-Specialty | $713K |
| 15 | Boston Medical Center Corporation Boston, MA · General Acute Care Hospital | $709K |
| 16 | District Hospital Partners L P Washington, DC · Nurse Practitioner, Family | $673K |
| 17 | Phoenix Children's Hospital Phoenix, AZ · General Acute Care Hospital Children | $666K |
| 18 | City Of Hope National Medical Center Duarte, CA · General Acute Care Hospital | $648K |
| 19 | Brigham & Womens Hospital Inc. Boston, MA · General Acute Care Hospital | $636K |
| 20 | 1558310474 | $593K |
Showing top 20 of 487 providers billing this code