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#1087 of 11K

90870

HCPCS Procedure Code

HCPCS code 90870 is the #1,087 most-billed Medicaid procedure code, with $42.0M in payments across 258K claims from 2018–2024. The national median cost per claim is $68.07. Costs vary widely — the 90th percentile is $331.59 per claim, 4.9× the median.

Total Paid

$42.0M

0.00% of all spending

Total Claims

258K

Providers

233

Avg Cost/Claim

$163

National Cost Distribution

How much do providers bill per claim for 90870? Based on 224 providers billing this code nationally.

Median

$68.07

Average

$119.78

Std Dev

$132.06

Max

$627.41

Percentile Distribution (Cost per Claim)

p10
$19.68
p25
$31.70
Median
$68.07
p75
$163.15
p90
$331.59
p95
$427.77
p99
$565.78

50% of providers bill between $31.70 and $163.15 per claim for this code.

90% bill between $19.68 and $331.59.

Top 1% bill above $565.78.

About This Procedure

HCPCS code 90870 was billed by 233 providers across 258K claims, totaling $42.0M in Medicaid payments from 2018–2024. This code was used for 96K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$68.07

Providers Billing

224

National Spending

$42.0M

Avg/Median Ratio

1.76×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for 90870

#ProviderTotal Paid
1Hennepin Healthcare System Inc

Minneapolis, MN · General Acute Care Hospital

$7.1M
21760623888$3.8M
31538185475$3.7M
41750466892$3.4M
51154876985$1.9M
6Long Island Jewish Medical Center

New Hyde Park, NY · General Acute Care Hospital

$1.6M
7Yale New Haven Hospital

New Haven, CT · General Acute Care Hospital

$1.2M
8Upmc Presbyterian Shadyside

Pittsburgh, PA · Clinic/Center

$1.1M
91215022157$1.1M
101427283795$846K
111982672762$805K
12Unm Hospital

Albuquerque, NM · General Acute Care Hospital

$742K
13Mainehealth

Portland, ME · Emergency Medicine

$739K
141801835970$711K
151386179711$677K
161225039399$653K
17Swedish Health Services

Seattle, WA · General Acute Care Hospital

$557K
18The General Hospital Corporation

Boston, MA · General Acute Care Hospital

$550K
19Hartford Hospital

Hartford, CT · General Acute Care Hospital

$507K
20Ohio State University Hospitals

Columbus, OH · General Acute Care Hospital

$421K

Showing top 20 of 233 providers billing this code