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#3516 of 11K

90694

HCPCS Procedure Code

HCPCS code 90694 is the #3,516 most-billed Medicaid procedure code, with $1.6M in payments across 168K claims from 2018–2024. The national median cost per claim is $6.60. Costs vary widely — the 90th percentile is $44.19 per claim, 6.7× the median.

Total Paid

$1.6M

0.00% of all spending

Total Claims

168K

Providers

1,846

Avg Cost/Claim

$9

National Cost Distribution

How much do providers bill per claim for 90694? Based on 825 providers billing this code nationally.

Median

$6.60

Average

$15.85

Std Dev

$23.65

Max

$295.93

Percentile Distribution (Cost per Claim)

p10
$0.60
p25
$2.15
Median
$6.60
p75
$19.43
p90
$44.19
p95
$64.96
p99
$104.98

50% of providers bill between $2.15 and $19.43 per claim for this code.

90% bill between $0.60 and $44.19.

Top 1% bill above $104.98.

About This Procedure

HCPCS code 90694 was billed by 1,846 providers across 168K claims, totaling $1.6M in Medicaid payments from 2018–2024. This code was used for 158K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$6.60

Providers Billing

825

National Spending

$1.6M

Avg/Median Ratio

2.40×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for 90694

#ProviderTotal Paid
1Permanente Medical Group Inc

Stockton, CA · Anesthesiology

$291K
2Homeland Health Specialists Inc

Minneapolis, MN · Registered Nurse, Community Health

$60K
3Boston Medical Center Corporation

Boston, MA · General Acute Care Hospital

$55K
4Group Health Plan, Inc.

Minneapolis, MN · Clinic/Center, Multi-Specialty

$53K
5Mount Sinai Hospital

New York, NY · Ambulance

$40K
6Park Nicollet Clinic

St Louis Park, MN · Obstetrics & Gynecology

$30K
7Stanford Health Care

Stanford, CA · General Acute Care Hospital

$26K
81881618544$23K
91356885875$20K
101740570696$19K
111265595268$18K
12Southern California Permanente Medical Group

San Diego, CA · Health Maintenance Organization

$16K
13Medstar Washington Hospital Center

Washington, DC · General Acute Care Hospital

$16K
141700886322$14K
15The New York And Presbyterian Hospital

New York, NY · General Acute Care Hospital

$14K
16New York City Health And Hospitals Corporation

Brooklyn, NY · Internal Medicine

$14K
17Southern California Permanente Medical Group

Bellflower, CA · Health Maintenance Organization

$13K
181780049189$13K
191639111057$13K
201912435173$12K

Showing top 20 of 1,846 providers billing this code