#4434 of 11K

90679

HCPCS Procedure Code

HCPCS code 90679 is the #4,434 most-billed Medicaid procedure code, with $593K in payments across 5,986 claims from 2018–2024. The national median cost per claim is $46.34. Costs vary widely — the 90th percentile is $290.38 per claim, 6.3× the median.

Total Paid

$593K

0.00% of all spending

Total Claims

5,986

Providers

Avg Cost/Claim

$99

National Cost Distribution

How much do providers bill per claim for 90679? Based on 55 providers billing this code nationally.

Median

$46.34

Average

$105.80

Std Dev

$111.35

Max

$332.96

Percentile Distribution (Cost per Claim)

p10

$0.95

p25

$9.90

Median

$46.34

p75

$176.77

p90

$290.38

p95

$306.51

p99

$331.58

50% of providers bill between $9.90 and $176.77 per claim for this code.

90% bill between $0.95 and $290.38.

Top 1% bill above $331.58.

About This Procedure

HCPCS code 90679 was billed by 99 providers across 5,986 claims, totaling $593K in Medicaid payments from 2018–2024. This code was used for 5,666 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$46.34

Providers Billing

National Spending

$593K

Avg/Median Ratio

2.28×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for 90679

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1003985755	$265K	$332.96	7.2× median	Top 1%
2	1356723605	$59K	$330.40	7.1× median	Top 10%
3	Spectrum Health Primary Care Partners Grand Rapids, MI · Psychologist, Clinical Child & Adolescent	$21K	$266.79	5.8× median	Above 75th
4	Kaiser Foundation Health Plan Of The Northwest Portland, OR · General Practice	$19K	$256.36	5.5× median	Above 75th
5	1942335096	$19K	$309.10	6.7× median	Top 10%
6	Southern California Permanente Medical Group Fontana, CA · Health Maintenance Organization	$19K	$152.42	3.3× median	Above Median
7	1386822336	$19K	$99.21	2.1× median	Above Median
8	1477521409	$19K	$290.62	6.3× median	Top 10%
9	1982863783	$18K	$167.80	3.6× median	Above Median
10	1528222577	$17K	$305.40	6.6× median	Top 10%
11	Southern California Permanente Medical Group Panorama City, CA · Health Maintenance Organization	$12K	$178.04	3.8× median	Above 75th
12	Permanente Medical Group Inc Stockton, CA · Anesthesiology	$12K	$172.57	3.7× median	Above Median
13	1497107775	$10K	$116.63	2.5× median	Above Median
14	1841373800	$10K	$144.53	3.1× median	Above Median
15	1164521407	$9K	$86.55	1.9× median	Above Median
16	1215971262	$8K	$290.00	6.3× median	Above 75th
17	1801303086	$5K	$200.15	4.3× median	Above 75th
18	1952333478	$5K	$175.50	3.8× median	Above Median
19	1376641993	$4K	$34.00	0.7× median	Below Median
20	1346285707	$4K	$229.44	5.0× median	Above 75th

Showing top 20 of 99 providers billing this code

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