93242
HCPCS Procedure Code
HCPCS code 93242 is the #3,590 most-billed Medicaid procedure code, with $1.5M in payments across 65K claims from 2018–2024. The national median cost per claim is $10.89. Costs vary widely — the 90th percentile is $66.27 per claim, 6.1× the median.
Total Paid
$1.5M
0.00% of all spending
Total Claims
65K
Providers
293
Avg Cost/Claim
$22
National Cost Distribution
How much do providers bill per claim for 93242? Based on 283 providers billing this code nationally.
Median
$10.89
Average
$26.92
Std Dev
$48.30
Max
$431.08
Percentile Distribution (Cost per Claim)
50% of providers bill between $6.30 and $26.26 per claim for this code.
90% bill between $3.24 and $66.27.
Top 1% bill above $203.29.
About This Procedure
HCPCS code 93242 was billed by 293 providers across 65K claims, totaling $1.5M in Medicaid payments from 2018–2024. This code was used for 61K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$10.89
Providers Billing
283
National Spending
$1.5M
Avg/Median Ratio
2.47×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for 93242
| # | Provider | Total Paid |
|---|---|---|
| 1 | Newark Beth Israel Medical Center Inc Newark, NJ · General Acute Care Hospital | $302K |
| 2 | Maimonides Medical Center Brooklyn, NY · General Acute Care Hospital | $82K |
| 3 | Montefiore Medical Center Bronx, NY · General Acute Care Hospital | $61K |
| 4 | Phoenix Children's Hospital Phoenix, AZ · General Acute Care Hospital Children | $48K |
| 5 | The Metrohealth System Cleveland, OH · General Acute Care Hospital | $39K |
| 6 | University Hospitals Cleveland Medical Center Cleveland, OH · General Acute Care Hospital | $33K |
| 7 | 1316994734 | $28K |
| 8 | Arkansas Childrens Hospital Little Rock, AR · Clinic/Center, Critical Access Hospital | $27K |
| 9 | Mount Sinai Hospital New York, NY · Ambulance | $27K |
| 10 | 1790869402 | $25K |
| 11 | Holzer Hospital Foundation Gallipolis, OH · General Acute Care Hospital Rural | $25K |
| 12 | 1063414258 | $24K |
| 13 | University Of Cincinnati Medical Center, Llc Cincinnati, OH · General Acute Care Hospital | $23K |
| 14 | University Of Washington Seattle, WA · Clinic/Center, Dental | $23K |
| 15 | Spectrum Health Hospitals Grand Rapids, MI · General Acute Care Hospital | $21K |
| 16 | Johns Hopkins All Children's Hospital Inc St Petersburg, FL · General Acute Care Hospital Children | $20K |
| 17 | 1467440743 | $18K |
| 18 | Mary Imogene Bassett Hospital Cooperstown, NY · General Acute Care Hospital, Rural | $18K |
| 19 | Yale New Haven Hospital New Haven, CT · General Acute Care Hospital | $16K |
| 20 | University Of Kentucky Lexington, KY · General Acute Care Hospital | $15K |
Showing top 20 of 293 providers billing this code