Statistical flags indicate unusual patterns — not proof of fraud or wrongdoing. Read our methodology

#3285 of 11K

92227

HCPCS Procedure Code

HCPCS code 92227 is the #3,285 most-billed Medicaid procedure code, with $2.0M in payments across 145K claims from 2018–2024. The national median cost per claim is $7.85. Costs vary widely — the 90th percentile is $31.14 per claim, 4.0× the median.

Total Paid

$2.0M

0.00% of all spending

Total Claims

145K

Providers

174

Avg Cost/Claim

$14

National Cost Distribution

How much do providers bill per claim for 92227? Based on 98 providers billing this code nationally.

Median

$7.85

Average

$15.16

Std Dev

$24.19

Max

$143.44

Percentile Distribution (Cost per Claim)

p10
$0.24
p25
$2.35
Median
$7.85
p75
$16.23
p90
$31.14
p95
$52.62
p99
$142.15

50% of providers bill between $2.35 and $16.23 per claim for this code.

90% bill between $0.24 and $31.14.

Top 1% bill above $142.15.

About This Procedure

HCPCS code 92227 was billed by 174 providers across 145K claims, totaling $2.0M in Medicaid payments from 2018–2024. This code was used for 141K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$7.85

Providers Billing

98

National Spending

$2.0M

Avg/Median Ratio

1.93×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for 92227

#ProviderTotal Paid
1Southern California Permanente Medical Group

Baldwin Park, CA · Health Maintenance Organization

$877K
2Community Care Health Network Llc

Nashville, TN · Nurse Practitioner

$656K
3Kaiser Foundation Health Plan Of The Northwest

Portland, OR · General Practice

$122K
4Mid Atlantic Pemanente Medical Group

Rockville, MD · Health Maintenance Organization

$63K
5Texas Children's Physician Group

Houston, TX · Pediatrics

$40K
6Dallas County Hospital District

Dallas, TX · Clinic/Center, Ambulatory Surgical

$39K
71184624009$27K
8Bronxcare Health System

Bronx, NY · General Acute Care Hospital

$17K
9Southern California Permanente Medical Group

Harbor City, CA · Health Maintenance Organization

$17K
101285105866$15K
11Southern California Permanente Medical Group

Los Angeles, CA · Health Maintenance Organization

$13K
121760599724$12K
131689158487$12K
141275801359$8K
151578552543$8K
161124182902$7K
171750845863$6K
18New York City Health And Hospitals Corporation

Bronx, NY · Internal Medicine

$6K
191871195644$5K
201942644661$5K

Showing top 20 of 174 providers billing this code