90681
HCPCS Procedure Code
HCPCS code 90681 is the #2,220 most-billed Medicaid procedure code, with $7.7M in payments across 2.0M claims from 2018–2024. The national median cost per claim is $5.74. Costs vary widely — the 90th percentile is $17.15 per claim, 3.0× the median.
Total Paid
$7.7M
0.00% of all spending
Total Claims
2.0M
Providers
4K
Avg Cost/Claim
$4
National Cost Distribution
How much do providers bill per claim for 90681? Based on 2K providers billing this code nationally.
Median
$5.74
Average
$7.58
Std Dev
$10.28
Max
$142.14
Percentile Distribution (Cost per Claim)
50% of providers bill between $0.87 and $10.66 per claim for this code.
90% bill between $0.05 and $17.15.
Top 1% bill above $40.06.
About This Procedure
HCPCS code 90681 was billed by 4K providers across 2.0M claims, totaling $7.7M in Medicaid payments from 2018–2024. This code was used for 1.9M unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$5.74
Providers Billing
2K
National Spending
$7.7M
Avg/Median Ratio
1.32×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for 90681
| # | Provider | Total Paid |
|---|---|---|
| 1 | Mid Atlantic Pemanente Medical Group Rockville, MD · Health Maintenance Organization | $765K |
| 2 | Arkansas Department Of Health Immunizations Little Rock, AR · Public Health or Welfare | $431K |
| 3 | Nationwide Children's Hospital Columbus, OH · General Acute Care Hospital | $254K |
| 4 | Nyu Langone Hospitals Brooklyn, NY · General Acute Care Hospital | $228K |
| 5 | Arkansas Childrens Hospital Little Rock, AR · Clinic/Center, Critical Access Hospital | $218K |
| 6 | The New York And Presbyterian Hospital New York, NY · General Acute Care Hospital | $132K |
| 7 | Virginia Commonwealth University Health System Authority Richmond, VA · General Acute Care Hospital | $116K |
| 8 | Children's Hospital Medical Center Cincinnati, OH · Clinic/Center, Primary Care | $79K |
| 9 | 1033138250 | $79K |
| 10 | 1619995016 | $77K |
| 11 | 1710945969 | $62K |
| 12 | 1952330649 | $53K |
| 13 | Maimonides Medical Center Brooklyn, NY · General Acute Care Hospital | $52K |
| 14 | 1629266903 | $50K |
| 15 | 1366591562 | $49K |
| 16 | 1427098169 | $47K |
| 17 | New York City Health And Hospitals Corporation Bronx, NY · Internal Medicine | $47K |
| 18 | 1538146717 | $46K |
| 19 | 1538597349 | $46K |
| 20 | 1578581963 | $44K |
Showing top 20 of 4K providers billing this code