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#3808 of 11K

92242

HCPCS Procedure Code

HCPCS code 92242 is the #3,808 most-billed Medicaid procedure code, with $1.1M in payments across 11K claims from 2018–2024. The national median cost per claim is $73.42. Costs vary widely — the 90th percentile is $150.53 per claim, 2.1× the median.

Total Paid

$1.1M

0.00% of all spending

Total Claims

11K

Providers

36

Avg Cost/Claim

$105

National Cost Distribution

How much do providers bill per claim for 92242? Based on 34 providers billing this code nationally.

Median

$73.42

Average

$79.07

Std Dev

$59.23

Max

$223.18

Percentile Distribution (Cost per Claim)

p10
$14.04
p25
$29.13
Median
$73.42
p75
$104.25
p90
$150.53
p95
$206.32
p99
$219.68

50% of providers bill between $29.13 and $104.25 per claim for this code.

90% bill between $14.04 and $150.53.

Top 1% bill above $219.68.

About This Procedure

HCPCS code 92242 was billed by 36 providers across 11K claims, totaling $1.1M in Medicaid payments from 2018–2024. This code was used for 10K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$73.42

Providers Billing

34

National Spending

$1.1M

Avg/Median Ratio

1.08×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 92242

#ProviderTotal Paid
11972704450$301K
21114033404$189K
31104221035$185K
41033170675$86K
51487798773$62K
61962767541$54K
71760541569$50K
81346663051$31K
91356330369$29K
101124071717$24K
111376574707$23K
121063561439$20K
131396755823$19K
141881613297$12K
151972663656$9K
161992040240$9K
171477529303$8K
181194779207$6K
191326249558$4K
201487602611$4K

Showing top 20 of 36 providers billing this code