#3295 of 11K

76519

HCPCS Procedure Code

HCPCS code 76519 is the #3,295 most-billed Medicaid procedure code, with $2.0M in payments across 69K claims from 2018–2024. The national median cost per claim is $22.90. Costs vary widely — the 90th percentile is $59.35 per claim, 2.6× the median.

Total Paid

$2.0M

0.00% of all spending

Total Claims

69K

Providers

246

Avg Cost/Claim

$29

National Cost Distribution

How much do providers bill per claim for 76519? Based on 239 providers billing this code nationally.

Median

$22.90

Average

$29.34

Std Dev

$22.39

Max

$108.67

Percentile Distribution (Cost per Claim)

p10

$6.40

p25

$14.11

Median

$22.90

p75

$39.23

p90

$59.35

p95

$72.03

p99

$99.36

50% of providers bill between $14.11 and $39.23 per claim for this code.

90% bill between $6.40 and $59.35.

Top 1% bill above $99.36.

About This Procedure

HCPCS code 76519 was billed by 246 providers across 69K claims, totaling $2.0M in Medicaid payments from 2018–2024. This code was used for 56K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$22.90

Providers Billing

239

National Spending

$2.0M

Avg/Median Ratio

1.28×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 76519

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1457515181	$283K	$70.43	3.1× median	Top 10%
2	1376639575	$160K	$93.12	4.1× median	Top 10%
3	1962413708	$136K	$50.75	2.2× median	Above 75th
4	1144219379	$110K	$61.85	2.7× median	Top 10%
5	1447299797	$91K	$29.84	1.3× median	Above Median
6	1598997009	$61K	$90.74	4.0× median	Top 10%
7	1114931052	$56K	$27.85	1.2× median	Above Median
8	1215228077	$51K	$88.60	3.9× median	Top 10%
9	1366562613	$44K	$56.11	2.5× median	Above 75th
10	1528066644	$40K	$7.28	0.3× median	Below Median
11	1215207683	$40K	$51.64	2.3× median	Above 75th
12	Cambridge Public Health Commission Cambridge, MA · General Acute Care Hospital	$37K	$52.90	2.3× median	Above 75th
13	1841520624	$37K	$39.36	1.7× median	Above 75th
14	1588703995	$34K	$18.57	0.8× median	Below Median
15	1528120235	$34K	$25.43	1.1× median	Above Median
16	1023063187	$33K	$21.07	0.9× median	Below Median
17	Umass Memorial Medical Center, Inc. Worcester, MA · General Acute Care Hospital	$28K	$45.10	2.0× median	Above 75th
18	1376593863	$24K	$21.04	0.9× median	Below Median
19	Froedtert Memorial Lutheran Hospital, Inc. Milwaukee, WI · Clinic/Center, Radiology	$23K	$39.02	1.7× median	Above Median
20	1114915311	$23K	$98.81	4.3× median	Top 10%

Showing top 20 of 246 providers billing this code

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