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#4518 of 11K

91307

HCPCS Procedure Code

HCPCS code 91307 is the #4,518 most-billed Medicaid procedure code, with $536K in payments across 793K claims from 2018–2024. The national median cost per claim is $0.01. Costs vary widely — the 90th percentile is $2.53 per claim, 253.0× the median.

Total Paid

$536K

0.00% of all spending

Total Claims

793K

Providers

4K

Avg Cost/Claim

$1

National Cost Distribution

How much do providers bill per claim for 91307? Based on 1K providers billing this code nationally.

Median

$0.01

Average

$3.53

Std Dev

$30.36

Max

$640.00

Percentile Distribution (Cost per Claim)

p10
$0.00
p25
$0.00
Median
$0.01
p75
$0.16
p90
$2.53
p95
$8.39
p99
$44.88

50% of providers bill between $0.00 and $0.16 per claim for this code.

90% bill between $0.00 and $2.53.

Top 1% bill above $44.88.

About This Procedure

HCPCS code 91307 was billed by 4K providers across 793K claims, totaling $536K in Medicaid payments from 2018–2024. This code was used for 677K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$0.01

Providers Billing

1K

National Spending

$536K

Avg/Median Ratio

353.00×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for 91307

#ProviderTotal Paid
1Alamo Navajo School Board, Inc.

Alamo, NM · Clinic/Center, Primary Care

$100K
21376104125$38K
3Utah Navajo Health System, Incorporated

Montezuma Creek, UT · Family Medicine

$32K
41740357169$32K
51497812721$24K
61124509948$20K
71548267420$16K
81124509955$15K
9Cambridge Public Health Commission

Cambridge, MA · General Acute Care Hospital

$14K
10Southcoast Hospitals Group, Inc

New Bedford, MA · General Acute Care Hospital

$14K
111336245828$12K
12Cdva Corp

Villalba, PR · Health Maintenance Organization

$11K
131285646455$10K
141790128080$9K
151518219633$9K
161326046467$9K
171255399036$8K
181851300149$8K
19Lexington Health Inc

West Columbia, SC · General Acute Care Hospital

$7K
201801835970$5K

Showing top 20 of 4K providers billing this code