90381
HCPCS Procedure Code
HCPCS code 90381 is the #4,095 most-billed Medicaid procedure code, with $855K in payments across 50K claims from 2018–2024. The national median cost per claim is $9.69. Costs vary widely — the 90th percentile is $94.47 per claim, 9.7× the median.
Total Paid
$855K
0.00% of all spending
Total Claims
50K
Providers
842
Avg Cost/Claim
$17
National Cost Distribution
How much do providers bill per claim for 90381? Based on 374 providers billing this code nationally.
Median
$9.69
Average
$41.27
Std Dev
$116.08
Max
$1,245.29
Percentile Distribution (Cost per Claim)
50% of providers bill between $2.12 and $18.86 per claim for this code.
90% bill between $0.00 and $94.47.
Top 1% bill above $504.82.
About This Procedure
HCPCS code 90381 was billed by 842 providers across 50K claims, totaling $855K in Medicaid payments from 2018–2024. This code was used for 46K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$9.69
Providers Billing
374
National Spending
$855K
Avg/Median Ratio
4.26×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for 90381
| # | Provider | Total Paid |
|---|---|---|
| 1 | Mid Atlantic Pemanente Medical Group Rockville, MD · Health Maintenance Organization | $125K |
| 2 | Montefiore Medical Center Bronx, NY · General Acute Care Hospital | $108K |
| 3 | Rector & Visitors Of The University Of Virginia Charlottesville, VA · General Acute Care Hospital | $49K |
| 4 | Children's Hospital & Research Center At Oakland Oakland, CA · General Acute Care Hospital | $37K |
| 5 | 1801857172 | $30K |
| 6 | The New York And Presbyterian Hospital New York, NY · General Acute Care Hospital | $29K |
| 7 | 1568901742 | $20K |
| 8 | 1205823879 | $17K |
| 9 | Arrowhead Regional Medical Center Colton, CA · General Acute Care Hospital | $15K |
| 10 | University Of Kentucky Lexington, KY · General Acute Care Hospital | $15K |
| 11 | The Nemours Foundation Wilmington, DE · Clinic/Center, Developmental Disabilities | $14K |
| 12 | Children's Hospital Medical Center Of Akron Akron, OH · General Acute Care Hospital Children | $14K |
| 13 | 1184904302 | $14K |
| 14 | 1922246842 | $13K |
| 15 | Arkansas Childrens Hospital Little Rock, AR · Clinic/Center, Critical Access Hospital | $12K |
| 16 | Arkansas Department Of Health Immunizations Little Rock, AR · Public Health or Welfare | $11K |
| 17 | 1285853135 | $11K |
| 18 | Nationwide Children's Hospital Columbus, OH · General Acute Care Hospital | $11K |
| 19 | 1699068676 | $10K |
| 20 | 1376508788 | $9K |
Showing top 20 of 842 providers billing this code