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#2097 of 11K

92081

HCPCS Procedure Code

HCPCS code 92081 is the #2,097 most-billed Medicaid procedure code, with $9.0M in payments across 1.0M claims from 2018–2024. The national median cost per claim is $11.63. Costs vary widely — the 90th percentile is $31.37 per claim, 2.7× the median.

Total Paid

$9.0M

0.00% of all spending

Total Claims

1.0M

Providers

992

Avg Cost/Claim

$9

National Cost Distribution

How much do providers bill per claim for 92081? Based on 790 providers billing this code nationally.

Median

$11.63

Average

$13.73

Std Dev

$13.23

Max

$88.77

Percentile Distribution (Cost per Claim)

p10
$0.22
p25
$1.11
Median
$11.63
p75
$23.57
p90
$31.37
p95
$35.21
p99
$49.61

50% of providers bill between $1.11 and $23.57 per claim for this code.

90% bill between $0.22 and $31.37.

Top 1% bill above $49.61.

About This Procedure

HCPCS code 92081 was billed by 992 providers across 1.0M claims, totaling $9.0M in Medicaid payments from 2018–2024. This code was used for 983K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$11.63

Providers Billing

790

National Spending

$9.0M

Avg/Median Ratio

1.18×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 92081

#ProviderTotal Paid
11730321795$293K
21184048449$231K
31205886314$213K
41114192390$204K
51619123379$198K
61912226689$189K
71144405762$163K
81073935466$162K
9La Maestra Family Clinic, Inc.

San Diego, CA · Clinic/Center, Federally Qualified Health Center (FQHC)

$156K
101760594089$150K
111447391693$147K
121992838015$137K
131255445300$134K
141922190719$133K
151588967749$132K
161346375763$121K
171508884438$109K
181851357560$102K
191841311867$100K
201477642510$98K

Showing top 20 of 992 providers billing this code