#4674 of 11K

93531

HCPCS Procedure Code

HCPCS code 93531 is the #4,674 most-billed Medicaid procedure code, with $458K in payments across 817 claims from 2018–2024. The national median cost per claim is $440.70. Costs vary widely — the 90th percentile is $1,872.06 per claim, 4.2× the median.

Total Paid

$458K

0.00% of all spending

Total Claims

817

Providers

Avg Cost/Claim

$560

National Cost Distribution

How much do providers bill per claim for 93531? Based on 18 providers billing this code nationally.

Median

$440.70

Average

$999.89

Std Dev

$1,282.23

Max

$5,536.38

Percentile Distribution (Cost per Claim)

p10

$239.43

p25

$297.74

Median

$440.70

p75

$1,275.62

p90

$1,872.06

p95

$2,699.59

p99

$4,969.02

50% of providers bill between $297.74 and $1,275.62 per claim for this code.

90% bill between $239.43 and $1,872.06.

Top 1% bill above $4,969.02.

About This Procedure

HCPCS code 93531 was billed by 20 providers across 817 claims, totaling $458K in Medicaid payments from 2018–2024. This code was used for 712 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$440.70

Providers Billing

National Spending

$458K

Avg/Median Ratio

2.27×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for 93531

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	Egleston Children's Hospital At Emory University Inc. Atlanta, GA · Pediatrics Pediatric Emergency Medicine	$144K	$1,731.95	3.9× median	Above 75th
2	Phoenix Children's Hospital Phoenix, AZ · General Acute Care Hospital Children	$72K	$5,536.38	12.6× median	Top 1%
3	State Of Mississippi - University Of Mississippi Medical Center Jackson, MS · General Acute Care Hospital	$39K	$826.34	1.9× median	Above Median
4	1841207750	$26K	$2,198.98	5.0× median	Top 10%
5	1093024101	$23K	$358.72	0.8× median	Below Median
6	1528078219	$18K	$429.83	1.0× median	Below Median
7	1396720371	$18K	$1,524.42	3.5× median	Above 75th
8	1811920549	$17K	$174.62	0.4× median	Below Median
9	Upmc Children's Hospital Of Pittsburgh Pittsburgh, PA · Clinic/Center	$16K	$1,307.40	3.0× median	Above 75th
10	1477503407	$15K	$400.34	0.9× median	Below Median
11	1144471715	$14K	$1,180.27	2.7× median	Above Median
12	1457389033	$14K	$230.99	0.5× median	Below Median
13	1982667663	$11K	$451.58	1.0× median	Above Median
14	1194099390	$7K	$243.05	0.6× median	Below Median
15	1932492626	$7K	$345.01	0.8× median	Below Median
16	1427256072	$7K	$510.21	1.2× median	Above Median
17	Ut Physicians Houston, TX · Emergency Medicine	$5K	$281.99	0.6× median	Below Median
18	1982678496	$4K	$265.97	0.6× median	Below Median
19	1881632818	$0	$0.00	0.0× median	Below Median
20	Medical University Hospital Authority Charleston, SC · General Acute Care Hospital	$0	$0.00	0.0× median	Below Median

Showing top 20 of 20 providers billing this code

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