91315
HCPCS Procedure Code
HCPCS code 91315 is the #8,040 most-billed Medicaid procedure code, with $7K in payments across 19K claims from 2018–2024. The national median cost per claim is $0.01. Costs vary widely — the 90th percentile is $1.34 per claim, 134.0× the median.
Total Paid
$7K
0.00% of all spending
Total Claims
19K
Providers
250
Avg Cost/Claim
$0
National Cost Distribution
How much do providers bill per claim for 91315? Based on 65 providers billing this code nationally.
Median
$0.01
Average
$1.21
Std Dev
$4.65
Max
$28.31
Percentile Distribution (Cost per Claim)
50% of providers bill between $0.00 and $0.01 per claim for this code.
90% bill between $0.00 and $1.34.
Top 1% bill above $23.98.
About This Procedure
HCPCS code 91315 was billed by 250 providers across 19K claims, totaling $7K in Medicaid payments from 2018–2024. This code was used for 17K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$0.01
Providers Billing
65
National Spending
$7K
Avg/Median Ratio
121.00×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for 91315
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1376104125 | $3K |
| 2 | 1164613857 | $2K |
| 3 | 1184904302 | $790 |
| 4 | Montefiore Medical Center Bronx, NY · General Acute Care Hospital | $435 |
| 5 | 1942687751 | $389 |
| 6 | 1619966892 | $370 |
| 7 | 1124013230 | $35 |
| 8 | 1255480042 | $32 |
| 9 | 1548221856 | $22 |
| 10 | 1346486594 | $16 |
| 11 | Children's Hospital Medical Center Of Akron Akron, OH · General Acute Care Hospital Children | $15 |
| 12 | 1558472308 | $13 |
| 13 | Nyu Langone Hospitals Brooklyn, NY · General Acute Care Hospital | $10 |
| 14 | 1548509276 | $9 |
| 15 | Children's Hospital Medical Center Cincinnati, OH · Clinic/Center, Primary Care | $7 |
| 16 | The Metrohealth System Cleveland, OH · General Acute Care Hospital | $4 |
| 17 | 1285141358 | $4 |
| 18 | The Nemours Foundation Wilmington, DE · Clinic/Center, Developmental Disabilities | $3 |
| 19 | 1215093216 | $2 |
| 20 | 1285853135 | $2 |
Showing top 20 of 250 providers billing this code