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#5709 of 11K

91037

HCPCS Procedure Code

HCPCS code 91037 is the #5,709 most-billed Medicaid procedure code, with $150K in payments across 3,182 claims from 2018–2024. The national median cost per claim is $45.23. Costs vary widely — the 90th percentile is $178.01 per claim, 3.9× the median.

Total Paid

$150K

0.00% of all spending

Total Claims

3,182

Providers

28

Avg Cost/Claim

$47

National Cost Distribution

How much do providers bill per claim for 91037? Based on 28 providers billing this code nationally.

Median

$45.23

Average

$74.37

Std Dev

$65.44

Max

$225.49

Percentile Distribution (Cost per Claim)

p10
$9.60
p25
$28.42
Median
$45.23
p75
$100.13
p90
$178.01
p95
$209.90
p99
$222.44

50% of providers bill between $28.42 and $100.13 per claim for this code.

90% bill between $9.60 and $178.01.

Top 1% bill above $222.44.

About This Procedure

HCPCS code 91037 was billed by 28 providers across 3,182 claims, totaling $150K in Medicaid payments from 2018–2024. This code was used for 3,002 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$45.23

Providers Billing

28

National Spending

$150K

Avg/Median Ratio

1.64×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for 91037

#ProviderTotal Paid
1Regents Of The University Of California

San Diego, CA · General Acute Care Hospital

$86K
21740231448$12K
31508968751$8K
41730440777$7K
51104906569$4K
61578672184$4K
71306064126$3K
8The Milton S Hershey Medical Center

Hershey, PA · General Acute Care Hospital

$3K
91700821808$3K
101972523348$3K
11Yale New Haven Hospital

New Haven, CT · General Acute Care Hospital

$2K
121356390769$2K
131336174366$2K
141023092053$2K
151760552343$2K
161215165485$1K
171336267137$1K
18Faculty Physicians And Surgeons Of Llusm

Redlands, CA · Pediatrics

$1K
191386682094$910
201811258510$739

Showing top 20 of 28 providers billing this code