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#4462 of 11K

91319

HCPCS Procedure Code

HCPCS code 91319 is the #4,462 most-billed Medicaid procedure code, with $575K in payments across 34K claims from 2018–2024. The national median cost per claim is $13.50. Costs vary widely — the 90th percentile is $65.84 per claim, 4.9× the median.

Total Paid

$575K

0.00% of all spending

Total Claims

34K

Providers

359

Avg Cost/Claim

$17

National Cost Distribution

How much do providers bill per claim for 91319? Based on 191 providers billing this code nationally.

Median

$13.50

Average

$25.78

Std Dev

$51.78

Max

$654.00

Percentile Distribution (Cost per Claim)

p10
$0.13
p25
$3.71
Median
$13.50
p75
$36.12
p90
$65.84
p95
$83.04
p99
$88.58

50% of providers bill between $3.71 and $36.12 per claim for this code.

90% bill between $0.13 and $65.84.

Top 1% bill above $88.58.

About This Procedure

HCPCS code 91319 was billed by 359 providers across 34K claims, totaling $575K in Medicaid payments from 2018–2024. This code was used for 32K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$13.50

Providers Billing

191

National Spending

$575K

Avg/Median Ratio

1.91×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for 91319

#ProviderTotal Paid
1Permanente Medical Group Inc

Stockton, CA · Anesthesiology

$80K
2Permanente Medical Group Inc

Richmond, CA · Internal Medicine

$45K
3Children's Hospital & Research Center At Oakland

Oakland, CA · General Acute Care Hospital

$38K
4Mid Atlantic Pemanente Medical Group

Rockville, MD · Health Maintenance Organization

$34K
5Permanente Medical Group Inc

Santa Clara, CA · Anesthesiology

$22K
6Southern California Permanente Medical Group

San Diego, CA · Health Maintenance Organization

$22K
7Children's Hospital Medical Center Of Akron

Akron, OH · General Acute Care Hospital Children

$20K
8Arkansas Childrens Hospital

Little Rock, AR · Clinic/Center, Critical Access Hospital

$19K
9Kaiser Foundation Health Plan Of The Northwest

Portland, OR · General Practice

$18K
10The New York And Presbyterian Hospital

New York, NY · General Acute Care Hospital

$17K
11Permanente Medical Group Inc

Vallejo, CA · Anesthesiology

$15K
12Southern California Permanente Medical Group

Anaheim, CA · Health Maintenance Organization

$14K
13Southern California Permanente Medical Group

Los Angeles, CA · Health Maintenance Organization

$13K
14Rector & Visitors Of The University Of Virginia

Charlottesville, VA · General Acute Care Hospital

$13K
15Dhhs Phs Naihs Shiprock Hospital

Shiprock, NM · General Acute Care Hospital

$12K
161841200664$12K
171235253485$8K
181386911691$7K
191184788291$7K
20Children's Hospital Medical Center

Cincinnati, OH · Clinic/Center, Primary Care

$7K

Showing top 20 of 359 providers billing this code