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#5547 of 11K

91035

HCPCS Procedure Code

HCPCS code 91035 is the #5,547 most-billed Medicaid procedure code, with $178K in payments across 956 claims from 2018–2024. The national median cost per claim is $100.84. Costs vary widely — the 90th percentile is $344.82 per claim, 3.4× the median.

Total Paid

$178K

0.00% of all spending

Total Claims

956

Providers

20

Avg Cost/Claim

$186

National Cost Distribution

How much do providers bill per claim for 91035? Based on 18 providers billing this code nationally.

Median

$100.84

Average

$147.05

Std Dev

$145.75

Max

$491.17

Percentile Distribution (Cost per Claim)

p10
$7.67
p25
$37.23
Median
$100.84
p75
$226.59
p90
$344.82
p95
$431.86
p99
$479.31

50% of providers bill between $37.23 and $226.59 per claim for this code.

90% bill between $7.67 and $344.82.

Top 1% bill above $479.31.

About This Procedure

HCPCS code 91035 was billed by 20 providers across 956 claims, totaling $178K in Medicaid payments from 2018–2024. This code was used for 919 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$100.84

Providers Billing

18

National Spending

$178K

Avg/Median Ratio

1.46×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 91035

#ProviderTotal Paid
11215392030$116K
21700821808$29K
3Yale New Haven Hospital

New Haven, CT · General Acute Care Hospital

$6K
4Baptist Healthcare System Inc

Corbin, KY · General Acute Care Hospital

$4K
51225053523$4K
61154368116$4K
7University Of Washington

Seattle, WA · Clinic/Center, Dental

$3K
81356390769$3K
91154483022$3K
101114483492$2K
111740231448$863
121518360296$768
131831150119$570
141336137629$455
151295761963$446
161588721500$284
171285852095$185
181760476659$132
191467433763$0
20Swedish Health Services

Seattle, WA · General Acute Care Hospital

$0

Showing top 20 of 20 providers billing this code