91038
HCPCS Procedure Code
HCPCS code 91038 is the #7,369 most-billed Medicaid procedure code, with $19K in payments across 216 claims from 2018–2024. The national median cost per claim is $55.96. Costs vary widely — the 90th percentile is $163.92 per claim, 2.9× the median.
Total Paid
$19K
0.00% of all spending
Total Claims
216
Providers
10
Avg Cost/Claim
$90
National Cost Distribution
How much do providers bill per claim for 91038? Based on 10 providers billing this code nationally.
Median
$55.96
Average
$91.37
Std Dev
$94.85
Max
$325.40
Percentile Distribution (Cost per Claim)
50% of providers bill between $32.98 and $128.16 per claim for this code.
90% bill between $23.75 and $163.92.
Top 1% bill above $309.25.
About This Procedure
HCPCS code 91038 was billed by 10 providers across 216 claims, totaling $19K in Medicaid payments from 2018–2024. This code was used for 193 unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$55.96
Providers Billing
10
National Spending
$19K
Avg/Median Ratio
1.63×
Moderately skewed
Top Providers Billing This Code
Ranked by total Medicaid payments for 91038
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1679934145 | $5K |
| 2 | 1457525917 | $4K |
| 3 | Rector & Visitors Of The University Of Virginia Charlottesville, VA · General Acute Care Hospital | $4K |
| 4 | 1023092053 | $3K |
| 5 | 1578121919 | $2K |
| 6 | Cook Children's Physician Network Fort Worth, TX · Medical Genetics, Clinical Genetics (M.D.) | $623 |
| 7 | Lsu Health Sciences Center Shreveport Faculty Group Practice Shreveport, LA · Oral & Maxillofacial Surgery | $510 |
| 8 | 1063419943 | $464 |
| 9 | Spectrum Health Primary Care Partners Grand Rapids, MI · Psychologist, Clinical Child & Adolescent | $417 |
| 10 | 1699874248 | $75 |
Showing top 10 of 10 providers billing this code