90961
HCPCS Procedure Code
HCPCS code 90961 is the #842 most-billed Medicaid procedure code, with $68.5M in payments across 1.0M claims from 2018–2024. The national median cost per claim is $47.22. Costs vary widely — the 90th percentile is $122.49 per claim, 2.6× the median.
Total Paid
$68.5M
0.01% of all spending
Total Claims
1.0M
Providers
2K
Avg Cost/Claim
$67
National Cost Distribution
How much do providers bill per claim for 90961? Based on 2K providers billing this code nationally.
Median
$47.22
Average
$60.72
Std Dev
$53.89
Max
$682.92
Percentile Distribution (Cost per Claim)
50% of providers bill between $26.46 and $78.42 per claim for this code.
90% bill between $13.45 and $122.49.
Top 1% bill above $245.43.
About This Procedure
HCPCS code 90961 was billed by 2K providers across 1.0M claims, totaling $68.5M in Medicaid payments from 2018–2024. This code was used for 947K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$47.22
Providers Billing
2K
National Spending
$68.5M
Avg/Median Ratio
1.29×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for 90961
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1316902208 | $4.4M |
| 2 | 1629010228 | $1.8M |
| 3 | 1235150400 | $1.2M |
| 4 | Hennepin Healthcare System Inc Minneapolis, MN · General Acute Care Hospital | $1.1M |
| 5 | 1962454140 | $1.1M |
| 6 | 1316997505 | $904K |
| 7 | 1902846306 | $786K |
| 8 | 1184735235 | $772K |
| 9 | 1104976158 | $762K |
| 10 | 1144372905 | $741K |
| 11 | 1932534021 | $685K |
| 12 | 1407897358 | $669K |
| 13 | Group Health Plan, Inc. Minneapolis, MN · Clinic/Center, Multi-Specialty | $659K |
| 14 | 1659316008 | $638K |
| 15 | 1821477746 | $633K |
| 16 | 1891888509 | $591K |
| 17 | 1568717742 | $567K |
| 18 | 1275604183 | $524K |
| 19 | 1063462950 | $467K |
| 20 | 1992000152 | $457K |
Showing top 20 of 2K providers billing this code