#5925 of 11K

93568

HCPCS Procedure Code

HCPCS code 93568 is the #5,925 most-billed Medicaid procedure code, with $118K in payments across 881 claims from 2018–2024. The national median cost per claim is $56.68. Costs vary widely — the 90th percentile is $157.97 per claim, 2.8× the median.

Total Paid

$118K

0.00% of all spending

Total Claims

881

Providers

Avg Cost/Claim

$134

National Cost Distribution

How much do providers bill per claim for 93568? Based on 18 providers billing this code nationally.

Median

$56.68

Average

$105.16

Std Dev

$171.08

Max

$763.87

Percentile Distribution (Cost per Claim)

p10

$22.77

p25

$35.15

Median

$56.68

p75

$91.98

p90

$157.97

p95

$261.87

p99

$663.47

50% of providers bill between $35.15 and $91.98 per claim for this code.

90% bill between $22.77 and $157.97.

Top 1% bill above $663.47.

About This Procedure

HCPCS code 93568 was billed by 21 providers across 881 claims, totaling $118K in Medicaid payments from 2018–2024. This code was used for 781 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$56.68

Providers Billing

National Spending

$118K

Avg/Median Ratio

1.86×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for 93568

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	Egleston Children's Hospital At Emory University Inc. Atlanta, GA · Pediatrics Pediatric Emergency Medicine	$82K	$763.87	13.5× median	Top 1%
2	1528078219	$6K	$151.41	2.7× median	Above 75th
3	1477550556	$4K	$93.67	1.7× median	Above 75th
4	1811920549	$4K	$24.19	0.4× median	Below Median
5	1457389033	$3K	$26.97	0.5× median	Below Median
6	Vanderbilt University Medical Center Nashville, TN · Transplant Surgery	$3K	$86.91	1.5× median	Above Median
7	1346230968	$3K	$173.28	3.1× median	Top 10%
8	1144213166	$2K	$139.17	2.5× median	Above 75th
9	1609915784	$2K	$44.26	0.8× median	Below Median
10	Children's Hospital Corporation Boston, MA · Clinic/Center	$2K	$73.48	1.3× median	Above Median
11	1801869250	$2K	$61.60	1.1× median	Above Median
12	University Physicians Incorporated Aurora, CO · Anesthesiology	$1K	$69.49	1.2× median	Above Median
13	Phoenix Children's Hospital Phoenix, AZ · Pediatrics	$1K	$39.04	0.7× median	Below Median
14	1801856786	$906	$37.73	0.7× median	Below Median
15	Cook Children's Physician Network Fort Worth, TX · Medical Genetics, Clinical Genetics (M.D.)	$673	$51.76	0.9× median	Below Median
16	1235148727	$480	$34.28	0.6× median	Below Median
17	1962493205	$234	$19.46	0.3× median	Below Median
18	Children's Hospital Medical Center Cincinnati, OH · Clinic/Center, Primary Care	$53	$2.31	0.0× median	Below Median
19	1881632818	$0	$0.00	0.0× median	Below Median
20	Phoenix Children's Hospital Phoenix, AZ · General Acute Care Hospital Children	$0	$0.00	0.0× median	Below Median

Showing top 20 of 21 providers billing this code

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