#3897 of 11K

94668

HCPCS Procedure Code

HCPCS code 94668 is the #3,897 most-billed Medicaid procedure code, with $1.0M in payments across 45K claims from 2018–2024. The national median cost per claim is $18.32. Costs vary widely — the 90th percentile is $126.15 per claim, 6.9× the median.

Total Paid

$1.0M

0.00% of all spending

Total Claims

45K

Providers

Avg Cost/Claim

$23

National Cost Distribution

How much do providers bill per claim for 94668? Based on 34 providers billing this code nationally.

Median

$18.32

Average

$97.92

Std Dev

$343.33

Max

$2,024.63

Percentile Distribution (Cost per Claim)

p10

$2.02

p25

$6.41

Median

$18.32

p75

$58.00

p90

$126.15

p95

$141.94

p99

$1,404.93

50% of providers bill between $6.41 and $58.00 per claim for this code.

90% bill between $2.02 and $126.15.

Top 1% bill above $1,404.93.

About This Procedure

HCPCS code 94668 was billed by 43 providers across 45K claims, totaling $1.0M in Medicaid payments from 2018–2024. This code was used for 11K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$18.32

Providers Billing

National Spending

$1.0M

Avg/Median Ratio

5.34×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for 94668

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	Egleston Children's Hospital At Emory University Inc. Atlanta, GA · Pediatrics Pediatric Emergency Medicine	$204K	$99.77	5.4× median	Above 75th
2	Scottish Rite Children's Medical Center Atlanta, GA · Pediatrics Pediatric Hematology-Oncology	$197K	$120.45	6.6× median	Above 75th
3	1619486388	$142K	$2,024.63	110.5× median	Top 1%
4	1578276457	$120K	$37.01	2.0× median	Above Median
5	1720792187	$116K	$59.92	3.3× median	Above 75th
6	1154982601	$51K	$6.31	0.3× median	Below Median
7	1912610890	$50K	$27.61	1.5× median	Above Median
8	1619661097	$30K	$49.58	2.7× median	Above Median
9	1053563304	$27K	$10.12	0.6× median	Below Median
10	1437156247	$27K	$111.10	6.1× median	Above 75th
11	1659792612	$22K	$31.16	1.7× median	Above Median
12	1689744450	$22K	$146.76	8.0× median	Top 10%
13	1891122263	$7K	$16.08	0.9× median	Below Median
14	Unm Hospital Albuquerque, NM · General Acute Care Hospital	$4K	$41.23	2.3× median	Above Median
15	1720341902	$3K	$7.93	0.4× median	Below Median
16	1356444814	$3K	$16.08	0.9× median	Below Median
17	Spartanburg Medical Center Spartanburg, SC · Ambulance	$2K	$128.60	7.0× median	Top 10%
18	Miami Valley Hospital Dayton, OH · General Acute Care Hospital	$2K	$67.94	3.7× median	Above 75th
19	Pikeville Medical Center Inc Pikeville, KY · General Acute Care Hospital	$2K	$52.25	2.9× median	Above Median
20	Baystate Medical Center Inc Springfield, MA · General Acute Care Hospital	$2K	$139.35	7.6× median	Top 10%

Showing top 20 of 43 providers billing this code

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