#1352 of 11K

90698

HCPCS Procedure Code

HCPCS code 90698 is the #1,352 most-billed Medicaid procedure code, with $26.1M in payments across 5.7M claims from 2018–2024. The national median cost per claim is $6.32. Costs vary widely — the 90th percentile is $21.27 per claim, 3.4× the median.

Total Paid

$26.1M

0.00% of all spending

Total Claims

5.7M

Providers

Avg Cost/Claim

National Cost Distribution

How much do providers bill per claim for 90698? Based on 4K providers billing this code nationally.

Median

$6.32

Average

$9.03

Std Dev

$12.39

Max

$255.04

Percentile Distribution (Cost per Claim)

p10

$0.09

p25

$0.94

Median

$6.32

p75

$12.62

p90

$21.27

p95

$26.63

p99

$45.68

50% of providers bill between $0.94 and $12.62 per claim for this code.

90% bill between $0.09 and $21.27.

Top 1% bill above $45.68.

About This Procedure

HCPCS code 90698 was billed by 7K providers across 5.7M claims, totaling $26.1M in Medicaid payments from 2018–2024. This code was used for 5.3M unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$6.32

Providers Billing

National Spending

$26.1M

Avg/Median Ratio

1.43×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 90698

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1376508788	$837K	$24.98	4.0× median	Top 10%
2	The Nemours Foundation Wilmington, DE · Clinic/Center, Developmental Disabilities	$551K	$11.31	1.8× median	Above Median
3	1104903749	$390K	$24.86	3.9× median	Top 10%
4	Children's Hospital Medical Center Of Akron Akron, OH · General Acute Care Hospital Children	$377K	$7.42	1.2× median	Above Median
5	1851335228	$370K	$36.87	5.8× median	Top 10%
6	Arkansas Department Of Health Immunizations Little Rock, AR · Public Health or Welfare	$369K	$13.23	2.1× median	Above 75th
7	1679593107	$323K	$33.37	5.3× median	Top 10%
8	1124105762	$305K	$31.90	5.0× median	Top 10%
9	1689639312	$295K	$100.57	15.9× median	Top 1%
10	1700966207	$289K	$33.05	5.2× median	Top 10%
11	1093152027	$260K	$64.24	10.2× median	Top 1%
12	1831151331	$223K	$34.91	5.5× median	Top 10%
13	1922246842	$202K	$99.48	15.7× median	Top 1%
14	1285853135	$190K	$20.70	3.3× median	Above 75th
15	1245307693	$178K	$21.68	3.4× median	Top 10%
16	1740397751	$172K	$18.94	3.0× median	Above 75th
17	1871872770	$159K	$36.54	5.8× median	Top 10%
18	1811091952	$153K	$9.54	1.5× median	Above Median
19	1235253485	$143K	$21.99	3.5× median	Top 10%
20	Children's Hospital Medical Center Cincinnati, OH · Clinic/Center, Primary Care	$137K	$6.39	1.0× median	Above Median

Showing top 20 of 7K providers billing this code

Related Procedures

90688$26.7M 90707MMR vaccine$18.7M 90697$13.7M 90700$10.5M 90696DTaP-IPV vaccine$6.4M

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