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#7184 of 11K

91040

HCPCS Procedure Code

HCPCS code 91040 is the #7,184 most-billed Medicaid procedure code, with $26K in payments across 351 claims from 2018–2024. The national median cost per claim is $86.83. Costs vary widely — the 90th percentile is $215.90 per claim, 2.5× the median.

Total Paid

$26K

0.00% of all spending

Total Claims

351

Providers

10

Avg Cost/Claim

$73

National Cost Distribution

How much do providers bill per claim for 91040? Based on 8 providers billing this code nationally.

Median

$86.83

Average

$103.18

Std Dev

$81.26

Max

$225.02

Percentile Distribution (Cost per Claim)

p10
$27.34
p25
$33.97
Median
$86.83
p75
$151.25
p90
$215.90
p95
$220.46
p99
$224.11

50% of providers bill between $33.97 and $151.25 per claim for this code.

90% bill between $27.34 and $215.90.

Top 1% bill above $224.11.

About This Procedure

HCPCS code 91040 was billed by 10 providers across 351 claims, totaling $26K in Medicaid payments from 2018–2024. This code was used for 301 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$86.83

Providers Billing

8

National Spending

$26K

Avg/Median Ratio

1.19×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 91040

#ProviderTotal Paid
1Yale New Haven Hospital

New Haven, CT · General Acute Care Hospital

$9K
21427007848$6K
31750678017$4K
4State Of Mississippi - University Of Mississippi Medical Center

Jackson, MS · General Acute Care Hospital

$3K
5Phoenix Children's Hospital

Phoenix, AZ · General Acute Care Hospital Children

$3K
61700821808$1K
71689897787$486
81023584216$208
91265423917$0
101679892913$0

Showing top 10 of 10 providers billing this code