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#2074 of 11K

91200

HCPCS Procedure Code

HCPCS code 91200 is the #2,074 most-billed Medicaid procedure code, with $9.4M in payments across 237K claims from 2018–2024. The national median cost per claim is $17.80. Costs vary widely — the 90th percentile is $79.22 per claim, 4.5× the median.

Total Paid

$9.4M

0.00% of all spending

Total Claims

237K

Providers

536

Avg Cost/Claim

$40

National Cost Distribution

How much do providers bill per claim for 91200? Based on 521 providers billing this code nationally.

Median

$17.80

Average

$32.37

Std Dev

$42.79

Max

$506.45

Percentile Distribution (Cost per Claim)

p10
$6.24
p25
$9.48
Median
$17.80
p75
$35.11
p90
$79.22
p95
$113.10
p99
$170.56

50% of providers bill between $9.48 and $35.11 per claim for this code.

90% bill between $6.24 and $79.22.

Top 1% bill above $170.56.

About This Procedure

HCPCS code 91200 was billed by 536 providers across 237K claims, totaling $9.4M in Medicaid payments from 2018–2024. This code was used for 223K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$17.80

Providers Billing

521

National Spending

$9.4M

Avg/Median Ratio

1.82×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for 91200

#ProviderTotal Paid
1Boston Medical Center Corporation

Boston, MA · General Acute Care Hospital

$578K
2The Cleveland Clinic Foundation

Cleveland, OH · General Acute Care Hospital

$455K
3Beth Israel Deaconess Medical Center, Inc.

Boston, MA · General Acute Care Hospital

$432K
41891716494$382K
5The Metrohealth System

Cleveland, OH · General Acute Care Hospital

$358K
6University Of Kentucky

Lexington, KY · General Acute Care Hospital

$251K
7Alaska Native Tribal Health Consortium

Anchorage, AK · General Acute Care Hospital

$239K
81063484483$190K
91144266024$168K
101447221742$150K
11Children's Hospital Corporation

Boston, MA · Clinic/Center

$147K
12Alameda Health System

Oakland, CA · General Acute Care Hospital

$145K
131306868252$133K
14Sage River Counseling

Seattle, WA · Counselor Mental Health

$128K
15Yuma Regional Medical Center

Yuma, AZ · General Acute Care Hospital

$128K
161235134024$124K
17Henry Ford Health System

Detroit, MI · General Acute Care Hospital

$124K
18University Of Cincinnati Medical Center, Llc

Cincinnati, OH · General Acute Care Hospital

$123K
191053325647$117K
201982799375$111K

Showing top 20 of 536 providers billing this code