90697
HCPCS Procedure Code
HCPCS code 90697 is the #1,796 most-billed Medicaid procedure code, with $13.7M in payments across 2.0M claims from 2018–2024. The national median cost per claim is $7.24. Costs vary widely — the 90th percentile is $35.17 per claim, 4.9× the median.
Total Paid
$13.7M
0.00% of all spending
Total Claims
2.0M
Providers
4K
Avg Cost/Claim
$7
National Cost Distribution
How much do providers bill per claim for 90697? Based on 2K providers billing this code nationally.
Median
$7.24
Average
$14.52
Std Dev
$22.84
Max
$209.44
Percentile Distribution (Cost per Claim)
50% of providers bill between $0.51 and $16.97 per claim for this code.
90% bill between $0.00 and $35.17.
Top 1% bill above $119.49.
About This Procedure
HCPCS code 90697 was billed by 4K providers across 2.0M claims, totaling $13.7M in Medicaid payments from 2018–2024. This code was used for 1.9M unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$7.24
Providers Billing
2K
National Spending
$13.7M
Avg/Median Ratio
2.01×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for 90697
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1144268277 | $1.5M |
| 2 | Children's Hospital Medical Center Of Akron Akron, OH · General Acute Care Hospital Children | $366K |
| 3 | Bronxcare Health System Bronx, NY · General Acute Care Hospital | $333K |
| 4 | The Nemours Foundation Wilmington, DE · Clinic/Center, Developmental Disabilities | $226K |
| 5 | Montefiore Medical Center Bronx, NY · General Acute Care Hospital | $175K |
| 6 | Arkansas Department Of Health Immunizations Little Rock, AR · Public Health or Welfare | $173K |
| 7 | The New York And Presbyterian Hospital New York, NY · General Acute Care Hospital | $155K |
| 8 | New York City Health And Hospitals Corporation Brooklyn, NY · Internal Medicine | $149K |
| 9 | Nationwide Children's Hospital Columbus, OH · General Acute Care Hospital | $146K |
| 10 | 1548494149 | $135K |
| 11 | 1326278490 | $132K |
| 12 | New York City Health And Hospitals Corporation Bronx, NY · Internal Medicine | $125K |
| 13 | Barrio Comprehensive Family Health Care Center, Inc. San Antonio, TX · Clinic/Center, Multi-Specialty | $119K |
| 14 | New York City Health And Hospitals Corporation Brooklyn, NY · Internal Medicine | $118K |
| 15 | 1770538696 | $118K |
| 16 | Arkansas Childrens Hospital Little Rock, AR · Clinic/Center, Critical Access Hospital | $113K |
| 17 | 1003824608 | $111K |
| 18 | 1598718256 | $108K |
| 19 | University Of Kentucky Lexington, KY · General Acute Care Hospital | $107K |
| 20 | 1760877245 | $100K |
Showing top 20 of 4K providers billing this code