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#6307 of 11K

91312

HCPCS Procedure Code

HCPCS code 91312 is the #6,307 most-billed Medicaid procedure code, with $76K in payments across 196K claims from 2018–2024. The national median cost per claim is $0.01. Costs vary widely — the 90th percentile is $2.10 per claim, 210.0× the median.

Total Paid

$76K

0.00% of all spending

Total Claims

196K

Providers

1K

Avg Cost/Claim

$0

National Cost Distribution

How much do providers bill per claim for 91312? Based on 258 providers billing this code nationally.

Median

$0.01

Average

$1.24

Std Dev

$5.29

Max

$50.42

Percentile Distribution (Cost per Claim)

p10
$0.00
p25
$0.00
Median
$0.01
p75
$0.06
p90
$2.10
p95
$5.72
p99
$28.82

50% of providers bill between $0.00 and $0.06 per claim for this code.

90% bill between $0.00 and $2.10.

Top 1% bill above $28.82.

About This Procedure

HCPCS code 91312 was billed by 1K providers across 196K claims, totaling $76K in Medicaid payments from 2018–2024. This code was used for 172K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$0.01

Providers Billing

258

National Spending

$76K

Avg/Median Ratio

124.00×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for 91312

#ProviderTotal Paid
1Virginia Commonwealth University Health System Authority

Richmond, VA · General Acute Care Hospital

$28K
2Cornell Scott Hill Health Corporation

New Haven, CT · Psychiatry & Neurology, Child & Adolescent Psychiatry

$14K
31528128899$7K
4Montefiore Medical Center

Bronx, NY · General Acute Care Hospital

$5K
51144302415$4K
61356307581$3K
71164613857$2K
81376104125$2K
91548267420$1K
101144203498$1K
11The New York And Presbyterian Hospital

New York, NY · General Acute Care Hospital

$1K
121275196222$760
131336245828$577
141184904302$513
151154396711$506
161497812721$475
171528157211$411
18The New York And Presbyterian Hospital

New York, NY · General Acute Care Hospital

$381
191962866095$320
20Mount Sinai Hospital

New York, NY · Ambulance

$257

Showing top 20 of 1K providers billing this code