76497
HCPCS Procedure Code
HCPCS code 76497 is the #4,432 most-billed Medicaid procedure code, with $594K in payments across 24K claims from 2018–2024. The national median cost per claim is $11.29. Costs vary widely — the 90th percentile is $363.83 per claim, 32.2× the median.
Total Paid
$594K
0.00% of all spending
Total Claims
24K
Providers
13
Avg Cost/Claim
$25
National Cost Distribution
How much do providers bill per claim for 76497? Based on 12 providers billing this code nationally.
Median
$11.29
Average
$273.30
Std Dev
$764.94
Max
$2,676.22
Percentile Distribution (Cost per Claim)
50% of providers bill between $3.51 and $52.00 per claim for this code.
90% bill between $2.57 and $363.83.
Top 1% bill above $2,424.69.
About This Procedure
HCPCS code 76497 was billed by 13 providers across 24K claims, totaling $594K in Medicaid payments from 2018–2024. This code was used for 22K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$11.29
Providers Billing
12
National Spending
$594K
Avg/Median Ratio
24.21×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for 76497
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1114187762 | $310K |
| 2 | University Of Wisconsin Hospitals And Clinics Authority Madison, WI · General Acute Care Hospital | $197K |
| 3 | 1356390264 | $48K |
| 4 | 1598784555 | $25K |
| 5 | 1801875208 | $5K |
| 6 | 1487930301 | $5K |
| 7 | 1659398519 | $2K |
| 8 | 1285025395 | $662 |
| 9 | 1073595179 | $601 |
| 10 | 1235123977 | $338 |
| 11 | 1144207101 | $123 |
| 12 | 1639186463 | $54 |
| 13 | 1821562307 | $0 |
Showing top 13 of 13 providers billing this code