Statistical flags indicate unusual patterns — not proof of fraud or wrongdoing. Read our methodology

#3769 of 11K

76513

HCPCS Procedure Code

HCPCS code 76513 is the #3,769 most-billed Medicaid procedure code, with $1.2M in payments across 24K claims from 2018–2024. The national median cost per claim is $45.02. Costs vary widely — the 90th percentile is $94.53 per claim, 2.1× the median.

Total Paid

$1.2M

0.00% of all spending

Total Claims

24K

Providers

48

Avg Cost/Claim

$50

National Cost Distribution

How much do providers bill per claim for 76513? Based on 46 providers billing this code nationally.

Median

$45.02

Average

$48.33

Std Dev

$30.60

Max

$117.64

Percentile Distribution (Cost per Claim)

p10
$9.94
p25
$20.65
Median
$45.02
p75
$65.05
p90
$94.53
p95
$103.89
p99
$114.82

50% of providers bill between $20.65 and $65.05 per claim for this code.

90% bill between $9.94 and $94.53.

Top 1% bill above $114.82.

About This Procedure

HCPCS code 76513 was billed by 48 providers across 24K claims, totaling $1.2M in Medicaid payments from 2018–2024. This code was used for 19K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$45.02

Providers Billing

46

National Spending

$1.2M

Avg/Median Ratio

1.07×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 76513

#ProviderTotal Paid
11083723845$201K
21528140464$186K
31447232913$145K
41063415537$135K
51124015946$75K
61699944298$66K
71679660617$58K
81124214499$51K
91922192343$49K
101588627749$44K
111235167644$24K
121013394360$23K
131356549349$20K
141760507495$18K
151336174374$18K
161841292802$12K
171154657112$12K
181033104773$7K
191568632271$6K
201326262817$5K

Showing top 20 of 48 providers billing this code