#3192 of 11K

92630

HCPCS Procedure Code

HCPCS code 92630 is the #3,192 most-billed Medicaid procedure code, with $2.3M in payments across 33K claims from 2018–2024. The national median cost per claim is $67.41. Costs vary widely — the 90th percentile is $140.06 per claim, 2.1× the median.

Total Paid

$2.3M

0.00% of all spending

Total Claims

33K

Providers

Avg Cost/Claim

$68

National Cost Distribution

How much do providers bill per claim for 92630? Based on 22 providers billing this code nationally.

Median

$67.41

Average

$80.57

Std Dev

$52.46

Max

$199.74

Percentile Distribution (Cost per Claim)

p10

$24.60

p25

$40.05

Median

$67.41

p75

$109.57

p90

$140.06

p95

$178.05

p99

$195.60

50% of providers bill between $40.05 and $109.57 per claim for this code.

90% bill between $24.60 and $140.06.

Top 1% bill above $195.60.

About This Procedure

HCPCS code 92630 was billed by 23 providers across 33K claims, totaling $2.3M in Medicaid payments from 2018–2024. This code was used for 12K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$67.41

Providers Billing

National Spending

$2.3M

Avg/Median Ratio

1.20×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 92630

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1558409706	$409K	$96.84	1.4× median	Above Median
2	1316029945	$309K	$104.06	1.5× median	Above Median
3	1679932925	$302K	$111.06	1.6× median	Above 75th
4	1265977714	$217K	$49.96	0.7× median	Below Median
5	Nationwide Children's Hospital Columbus, OH · General Acute Care Hospital	$202K	$81.21	1.2× median	Above Median
6	1831231943	$191K	$22.48	0.3× median	Below Median
7	1831415645	$161K	$126.46	1.9× median	Above 75th
8	1831226745	$141K	$105.10	1.6× median	Above Median
9	Johns Hopkins All Children's Hospital Inc St Petersburg, FL · General Acute Care Hospital Children	$108K	$53.61	0.8× median	Below Median
10	The Nemours Foundation Orlando, FL · General Acute Care Hospital Children	$62K	$131.86	2.0× median	Above 75th
11	1306952726	$46K	$199.74	3.0× median	Top 1%
12	1215006150	$37K	$50.99	0.8× median	Below Median
13	1801059613	$26K	$44.57	0.7× median	Below Median
14	1689221442	$16K	$39.41	0.6× median	Below Median
15	1902136724	$9K	$31.03	0.5× median	Below Median
16	1942743695	$7K	$180.00	2.7× median	Top 10%
17	1013994359	$5K	$140.97	2.1× median	Top 10%
18	1982063533	$4K	$30.23	0.4× median	Below Median
19	Cook Children's Medical Center Fort Worth, TX · General Acute Care Hospital Children	$3K	$91.57	1.4× median	Above Median
20	1487769709	$3K	$23.98	0.4× median	Below Median

Showing top 20 of 23 providers billing this code

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