#3484 of 11K

91065

HCPCS Procedure Code

HCPCS code 91065 is the #3,484 most-billed Medicaid procedure code, with $1.6M in payments across 35K claims from 2018–2024. The national median cost per claim is $37.81. Costs vary widely — the 90th percentile is $108.43 per claim, 2.9× the median.

Total Paid

$1.6M

0.00% of all spending

Total Claims

35K

Providers

110

Avg Cost/Claim

$46

National Cost Distribution

How much do providers bill per claim for 91065? Based on 109 providers billing this code nationally.

Median

$37.81

Average

$51.71

Std Dev

$63.08

Max

$541.47

Percentile Distribution (Cost per Claim)

p10

$7.81

p25

$15.77

Median

$37.81

p75

$64.28

p90

$108.43

p95

$141.98

p99

$214.54

50% of providers bill between $15.77 and $64.28 per claim for this code.

90% bill between $7.81 and $108.43.

Top 1% bill above $214.54.

About This Procedure

HCPCS code 91065 was billed by 110 providers across 35K claims, totaling $1.6M in Medicaid payments from 2018–2024. This code was used for 31K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$37.81

Providers Billing

109

National Spending

$1.6M

Avg/Median Ratio

1.37×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 91065

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1891056370	$181K	$55.00	1.5× median	Above Median
2	1225053523	$156K	$54.02	1.4× median	Above Median
3	1619901642	$151K	$104.90	2.8× median	Above 75th
4	State University Of Iowa Iowa City, IA · General Acute Care Hospital	$116K	$102.20	2.7× median	Above 75th
5	Regents Of The University Of Michigan Ann Arbor, MI · Clinic/Center, End-Stage Renal Disease (ESRD) Treatment	$109K	$75.60	2.0× median	Above 75th
6	Brigham & Womens Hospital Inc. Boston, MA · General Acute Care Hospital	$102K	$160.63	4.2× median	Top 10%
7	1477629285	$74K	$70.03	1.9× median	Above 75th
8	1710306436	$54K	$37.81	1.0× median	Below Median
9	1639172372	$43K	$118.37	3.1× median	Top 10%
10	1568638047	$39K	$41.14	1.1× median	Above Median
11	Regents Of The University Of California San Diego, CA · General Acute Care Hospital	$38K	$27.70	0.7× median	Below Median
12	1831625342	$38K	$52.17	1.4× median	Above Median
13	1386735033	$28K	$41.17	1.1× median	Above Median
14	Stanford Health Care Stanford, CA · General Acute Care Hospital	$27K	$53.52	1.4× median	Above Median
15	1700949336	$27K	$22.24	0.6× median	Below Median
16	North Carolina Baptist Hospital Winston Salem, NC · General Acute Care Hospital	$27K	$541.47	14.3× median	Top 1%
17	1619161171	$25K	$57.64	1.5× median	Above Median
18	1184766107	$24K	$49.20	1.3× median	Above Median
19	1609804541	$21K	$39.65	1.0× median	Above Median
20	1255305520	$21K	$61.77	1.6× median	Above Median

Showing top 20 of 110 providers billing this code

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