#4615 of 11K

76970

HCPCS Procedure Code

HCPCS code 76970 is the #4,615 most-billed Medicaid procedure code, with $486K in payments across 10K claims from 2018–2024. The national median cost per claim is $45.37.

Total Paid

$486K

0.00% of all spending

Total Claims

10K

Providers

Avg Cost/Claim

$47

National Cost Distribution

How much do providers bill per claim for 76970? Based on 47 providers billing this code nationally.

Median

$45.37

Average

$46.01

Std Dev

$24.44

Max

$100.16

Percentile Distribution (Cost per Claim)

p10

$15.72

p25

$27.93

Median

$45.37

p75

$64.57

p90

$78.37

p95

$81.13

p99

$94.85

50% of providers bill between $27.93 and $64.57 per claim for this code.

90% bill between $15.72 and $78.37.

Top 1% bill above $94.85.

About This Procedure

HCPCS code 76970 was billed by 48 providers across 10K claims, totaling $486K in Medicaid payments from 2018–2024. This code was used for 7,710 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$45.37

Providers Billing

National Spending

$486K

Avg/Median Ratio

1.01×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 76970

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1124079769	$75K	$53.49	1.2× median	Above Median
2	1891895637	$67K	$34.84	0.8× median	Below Median
3	1073929121	$60K	$53.90	1.2× median	Above Median
4	1275994766	$50K	$80.68	1.8× median	Top 10%
5	1508805805	$27K	$67.79	1.5× median	Above 75th
6	1508912452	$23K	$38.97	0.9× median	Below Median
7	1477972933	$20K	$21.73	0.5× median	Below Median
8	1962868687	$17K	$55.32	1.2× median	Above Median
9	1649585399	$16K	$59.89	1.3× median	Above Median
10	1487682662	$15K	$81.32	1.8× median	Top 10%
11	1639518848	$12K	$76.91	1.7× median	Above 75th
12	1730439704	$12K	$77.11	1.7× median	Above 75th
13	The William W Backus Hospital Norwich, CT · Clinic/Center, Emergency Care	$10K	$88.62	2.0× median	Top 10%
14	The Hospital Of Central Connecticut At New Britain General And Bradley New Britain, CT · General Acute Care Hospital	$10K	$75.69	1.7× median	Above 75th
15	1881848687	$9K	$62.50	1.4× median	Above Median
16	Hartford Hospital Hartford, CT · General Acute Care Hospital	$9K	$80.25	1.8× median	Top 10%
17	1427007848	$6K	$100.16	2.2× median	Top 1%
18	1508249202	$5K	$35.14	0.8× median	Below Median
19	1417340134	$5K	$28.68	0.6× median	Below Median
20	1710472782	$5K	$37.87	0.8× median	Below Median

Showing top 20 of 48 providers billing this code

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