90863
HCPCS Procedure Code
HCPCS code 90863 is the #1,698 most-billed Medicaid procedure code, with $15.9M in payments across 332K claims from 2018–2024. The national median cost per claim is $29.71. Costs vary widely — the 90th percentile is $76.22 per claim, 2.6× the median.
Total Paid
$15.9M
0.00% of all spending
Total Claims
332K
Providers
340
Avg Cost/Claim
$48
National Cost Distribution
How much do providers bill per claim for 90863? Based on 206 providers billing this code nationally.
Median
$29.71
Average
$36.71
Std Dev
$45.94
Max
$436.04
Percentile Distribution (Cost per Claim)
50% of providers bill between $6.16 and $43.01 per claim for this code.
90% bill between $0.38 and $76.22.
Top 1% bill above $179.07.
About This Procedure
HCPCS code 90863 was billed by 340 providers across 332K claims, totaling $15.9M in Medicaid payments from 2018–2024. This code was used for 268K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$29.71
Providers Billing
206
National Spending
$15.9M
Avg/Median Ratio
1.24×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for 90863
| # | Provider | Total Paid |
|---|---|---|
| 1 | Virtua - West Jersey Health System Inc. Voorhees, NJ · General Acute Care Hospital | $1.7M |
| 2 | 1114002573 | $1.2M |
| 3 | 1295878122 | $1.1M |
| 4 | 1215918339 | $966K |
| 5 | 1932167277 | $924K |
| 6 | 1043350440 | $694K |
| 7 | 1932533361 | $572K |
| 8 | 1730174111 | $564K |
| 9 | 1720074644 | $558K |
| 10 | 1760542278 | $558K |
| 11 | 1851414965 | $357K |
| 12 | 1730692344 | $350K |
| 13 | 1003218553 | $297K |
| 14 | 1740211333 | $290K |
| 15 | 1992867998 | $268K |
| 16 | 1609886787 | $260K |
| 17 | 1467449157 | $259K |
| 18 | 1811049653 | $257K |
| 19 | 1801964952 | $238K |
| 20 | 1841332400 | $217K |
Showing top 20 of 340 providers billing this code