#3830 of 11K

93797

HCPCS Procedure Code

HCPCS code 93797 is the #3,830 most-billed Medicaid procedure code, with $1.1M in payments across 23K claims from 2018–2024. The national median cost per claim is $33.41. Costs vary widely — the 90th percentile is $71.36 per claim, 2.1× the median.

Total Paid

$1.1M

0.00% of all spending

Total Claims

23K

Providers

Avg Cost/Claim

$48

National Cost Distribution

How much do providers bill per claim for 93797? Based on 34 providers billing this code nationally.

Median

$33.41

Average

$39.05

Std Dev

$36.22

Max

$180.45

Percentile Distribution (Cost per Claim)

p10

$4.84

p25

$12.60

Median

$33.41

p75

$55.60

p90

$71.36

p95

$88.06

p99

$155.23

50% of providers bill between $12.60 and $55.60 per claim for this code.

90% bill between $4.84 and $71.36.

Top 1% bill above $155.23.

About This Procedure

HCPCS code 93797 was billed by 41 providers across 23K claims, totaling $1.1M in Medicaid payments from 2018–2024. This code was used for 5,376 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$33.41

Providers Billing

National Spending

$1.1M

Avg/Median Ratio

1.17×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 93797

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	Ohiohealth Corporation Columbus, OH · General Acute Care Hospital	$189K	$72.36	2.2× median	Top 10%
2	The Miriam Hospital Providence, RI · General Acute Care Hospital	$187K	$79.45	2.4× median	Top 10%
3	Henry Ford Health System Detroit, MI · General Acute Care Hospital	$165K	$66.15	2.0× median	Above 75th
4	1881980803	$141K	$40.11	1.2× median	Above Median
5	1891310124	$118K	$104.04	3.1× median	Top 10%
6	Presbyterian Healthcare Services Albuquerque, NM · Emergency Medicine	$69K	$33.97	1.0× median	Above Median
7	The General Hospital Corporation Boston, MA · General Acute Care Hospital	$64K	$42.33	1.3× median	Above Median
8	University Of Wisconsin Hospitals And Clinics Authority Madison, WI · General Acute Care Hospital	$35K	$42.11	1.3× median	Above Median
9	Baystate Medical Center Inc Springfield, MA · General Acute Care Hospital	$24K	$31.65	0.9× median	Below Median
10	1235196510	$23K	$32.84	1.0× median	Below Median
11	1760794044	$21K	$54.36	1.6× median	Above Median
12	1578677811	$20K	$43.02	1.3× median	Above Median
13	Mainehealth Portland, ME · Emergency Medicine	$17K	$56.02	1.7× median	Above 75th
14	1730238007	$8K	$69.03	2.1× median	Above 75th
15	1841231461	$4K	$4.56	0.1× median	Below Median
16	1649253998	$4K	$180.45	5.4× median	Top 1%
17	1578504056	$3K	$59.28	1.8× median	Above 75th
18	1487904546	$3K	$3.70	0.1× median	Below Median
19	1427030774	$3K	$8.44	0.3× median	Below Median
20	1427181007	$2K	$12.57	0.4× median	Below Median

Showing top 20 of 41 providers billing this code

Related Procedures

93798Cardiac rehabilitation with continuous ECG monitoring, per session$20.1M 93793$2.2M 93799$417K 93788$180K 93790$146K

← All procedures Top providers →