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#2349 of 11K

92540

HCPCS Procedure Code

HCPCS code 92540 is the #2,349 most-billed Medicaid procedure code, with $6.5M in payments across 121K claims from 2018–2024. The national median cost per claim is $59.84.

Total Paid

$6.5M

0.00% of all spending

Total Claims

121K

Providers

268

Avg Cost/Claim

$54

National Cost Distribution

How much do providers bill per claim for 92540? Based on 258 providers billing this code nationally.

Median

$59.84

Average

$57.74

Std Dev

$43.20

Max

$514.98

Percentile Distribution (Cost per Claim)

p10
$17.29
p25
$34.60
Median
$59.84
p75
$76.78
p90
$86.71
p95
$93.44
p99
$149.63

50% of providers bill between $34.60 and $76.78 per claim for this code.

90% bill between $17.29 and $86.71.

Top 1% bill above $149.63.

About This Procedure

HCPCS code 92540 was billed by 268 providers across 121K claims, totaling $6.5M in Medicaid payments from 2018–2024. This code was used for 117K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$59.84

Providers Billing

258

National Spending

$6.5M

Avg/Median Ratio

0.96×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 92540

#ProviderTotal Paid
11659849040$830K
21275916652$748K
31033548581$267K
41275647851$232K
51164594149$222K
61609861244$195K
7New York Network Ipa Inc

Brooklyn, NY · Exclusive Provider Organization

$172K
81174606438$142K
91457731242$135K
101013334234$122K
111598941577$121K
121013259084$110K
131831517002$107K
141669407185$103K
151043497571$101K
161174537948$96K
171184766107$90K
181982982336$90K
191699059451$90K
201912037102$87K

Showing top 20 of 268 providers billing this code