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#2969 of 11K

76981

HCPCS Procedure Code

HCPCS code 76981 is the #2,969 most-billed Medicaid procedure code, with $2.9M in payments across 63K claims from 2018–2024. The national median cost per claim is $42.75. Costs vary widely — the 90th percentile is $98.40 per claim, 2.3× the median.

Total Paid

$2.9M

0.00% of all spending

Total Claims

63K

Providers

282

Avg Cost/Claim

$46

National Cost Distribution

How much do providers bill per claim for 76981? Based on 264 providers billing this code nationally.

Median

$42.75

Average

$49.74

Std Dev

$41.09

Max

$332.70

Percentile Distribution (Cost per Claim)

p10
$9.27
p25
$16.82
Median
$42.75
p75
$73.89
p90
$98.40
p95
$117.72
p99
$163.99

50% of providers bill between $16.82 and $73.89 per claim for this code.

90% bill between $9.27 and $98.40.

Top 1% bill above $163.99.

About This Procedure

HCPCS code 76981 was billed by 282 providers across 63K claims, totaling $2.9M in Medicaid payments from 2018–2024. This code was used for 58K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$42.75

Providers Billing

264

National Spending

$2.9M

Avg/Median Ratio

1.16×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 76981

#ProviderTotal Paid
11831603505$262K
21295181477$214K
3Children's Hospital & Research Center At Oakland

Oakland, CA · General Acute Care Hospital

$174K
41972004489$154K
5Ohio State University Hospitals

Columbus, OH · General Acute Care Hospital

$107K
6Englewood Hospital And Medical Center

Englewood, NJ · General Acute Care Hospital

$68K
7Holyoke Medical Center, Inc.

Holyoke, MA · Clinic/Center, Adult Mental Health

$58K
8University Of California Irvine

Orange, CA · General Acute Care Hospital

$57K
91790851095$57K
101720395247$56K
111962537407$47K
121275630527$45K
131710176870$43K
141871633099$38K
151396862116$38K
16Montefiore Medical Center

Bronx, NY · General Acute Care Hospital

$33K
17Texas Children's Hospital

Houston, TX · General Acute Care Hospital Children

$32K
181811032550$32K
19The Cooper Health System

Camden, NJ · General Acute Care Hospital

$32K
20Rhode Island Hospital

Providence, RI · General Acute Care Hospital

$31K

Showing top 20 of 282 providers billing this code