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#2449 of 11K

94200

HCPCS Procedure Code

HCPCS code 94200 is the #2,449 most-billed Medicaid procedure code, with $5.7M in payments across 464K claims from 2018–2024. The national median cost per claim is $7.93. Costs vary widely — the 90th percentile is $19.96 per claim, 2.5× the median.

Total Paid

$5.7M

0.00% of all spending

Total Claims

464K

Providers

383

Avg Cost/Claim

$12

National Cost Distribution

How much do providers bill per claim for 94200? Based on 341 providers billing this code nationally.

Median

$7.93

Average

$10.24

Std Dev

$11.18

Max

$112.82

Percentile Distribution (Cost per Claim)

p10
$0.85
p25
$3.16
Median
$7.93
p75
$14.33
p90
$19.96
p95
$24.50
p99
$53.53

50% of providers bill between $3.16 and $14.33 per claim for this code.

90% bill between $0.85 and $19.96.

Top 1% bill above $53.53.

About This Procedure

HCPCS code 94200 was billed by 383 providers across 464K claims, totaling $5.7M in Medicaid payments from 2018–2024. This code was used for 295K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$7.93

Providers Billing

341

National Spending

$5.7M

Avg/Median Ratio

1.29×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 94200

#ProviderTotal Paid
11265812119$1.1M
21114340528$892K
31881074748$845K
41972983815$330K
51508868670$329K
61750366118$263K
71851457774$157K
81710906995$116K
91184902405$93K
101639371586$89K
111780670919$88K
121740555754$67K
131639172372$64K
141821454505$58K
151235596677$50K
161083658918$42K
171043318207$40K
18Capital Health System, Inc.

Pennington, NJ · General Acute Care Hospital

$39K
191265521371$36K
201366871378$34K

Showing top 20 of 383 providers billing this code