#3713 of 11K

91122

HCPCS Procedure Code

HCPCS code 91122 is the #3,713 most-billed Medicaid procedure code, with $1.3M in payments across 15K claims from 2018–2024. The national median cost per claim is $97.26.

Total Paid

$1.3M

0.00% of all spending

Total Claims

15K

Providers

Avg Cost/Claim

$89

National Cost Distribution

How much do providers bill per claim for 91122? Based on 60 providers billing this code nationally.

Median

$97.26

Average

$116.20

Std Dev

$87.46

Max

$541.71

Percentile Distribution (Cost per Claim)

p10

$41.43

p25

$56.46

Median

$97.26

p75

$153.87

p90

$180.26

p95

$202.76

p99

$448.47

50% of providers bill between $56.46 and $153.87 per claim for this code.

90% bill between $41.43 and $180.26.

Top 1% bill above $448.47.

About This Procedure

HCPCS code 91122 was billed by 62 providers across 15K claims, totaling $1.3M in Medicaid payments from 2018–2024. This code was used for 11K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$97.26

Providers Billing

National Spending

$1.3M

Avg/Median Ratio

1.19×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 91122

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1164736401	$204K	$140.71	1.4× median	Above Median
2	1225053523	$150K	$158.21	1.6× median	Above 75th
3	The Cleveland Clinic Foundation Cleveland, OH · General Acute Care Hospital	$115K	$40.73	0.4× median	Below Median
4	1215940796	$85K	$187.38	1.9× median	Top 10%
5	1992982680	$83K	$82.88	0.9× median	Below Median
6	1578744892	$77K	$172.04	1.8× median	Above 75th
7	1932216389	$71K	$65.66	0.7× median	Below Median
8	Regents Of The University Of Michigan Ann Arbor, MI · Clinic/Center, End-Stage Renal Disease (ESRD) Treatment	$48K	$120.55	1.2× median	Above Median
9	1467452086	$48K	$106.82	1.1× median	Above Median
10	1407397235	$46K	$156.91	1.6× median	Above 75th
11	1386711877	$43K	$77.53	0.8× median	Below Median
12	Stanford Health Care Stanford, CA · General Acute Care Hospital	$38K	$89.58	0.9× median	Below Median
13	1538212170	$29K	$57.14	0.6× median	Below Median
14	Yale New Haven Hospital New Haven, CT · General Acute Care Hospital	$22K	$169.44	1.7× median	Above 75th
15	1518221779	$21K	$75.39	0.8× median	Below Median
16	Wake Forest University Health Sciences Winston Salem, NC · Clinic/Center, Multi-Specialty	$20K	$67.21	0.7× median	Below Median
17	North Carolina Baptist Hospital Winston Salem, NC · General Acute Care Hospital	$20K	$383.67	3.9× median	Top 10%
18	1801827639	$18K	$48.35	0.5× median	Below Median
19	1437292927	$12K	$101.13	1.0× median	Above Median
20	1922273101	$11K	$138.78	1.4× median	Above Median

Showing top 20 of 62 providers billing this code

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