94680
HCPCS Procedure Code
HCPCS code 94680 is the #5,413 most-billed Medicaid procedure code, with $205K in payments across 9,571 claims from 2018–2024. The national median cost per claim is $14.12. Costs vary widely — the 90th percentile is $83.48 per claim, 5.9× the median.
Total Paid
$205K
0.00% of all spending
Total Claims
9,571
Providers
31
Avg Cost/Claim
$21
National Cost Distribution
How much do providers bill per claim for 94680? Based on 27 providers billing this code nationally.
Median
$14.12
Average
$30.95
Std Dev
$31.27
Max
$115.84
Percentile Distribution (Cost per Claim)
50% of providers bill between $10.43 and $45.49 per claim for this code.
90% bill between $6.96 and $83.48.
Top 1% bill above $109.93.
About This Procedure
HCPCS code 94680 was billed by 31 providers across 9,571 claims, totaling $205K in Medicaid payments from 2018–2024. This code was used for 8,029 unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$14.12
Providers Billing
27
National Spending
$205K
Avg/Median Ratio
2.19×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for 94680
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1366574071 | $47K |
| 2 | Children's Hospital Corporation Boston, MA · Clinic/Center | $31K |
| 3 | Egleston Children's Hospital At Emory University Inc. Atlanta, GA · Pediatrics Pediatric Emergency Medicine | $31K |
| 4 | 1851352256 | $22K |
| 5 | 1144556333 | $15K |
| 6 | 1972669661 | $10K |
| 7 | 1255390837 | $10K |
| 8 | 1598977670 | $7K |
| 9 | 1689744450 | $7K |
| 10 | 1609915784 | $5K |
| 11 | 1538128053 | $5K |
| 12 | Yale New Haven Hospital New Haven, CT · General Acute Care Hospital | $3K |
| 13 | 1265491641 | $2K |
| 14 | 1679599013 | $2K |
| 15 | 1710065933 | $2K |
| 16 | 1902925001 | $1K |
| 17 | 1003849621 | $1K |
| 18 | Children's Hospital Medical Center Cincinnati, OH · Clinic/Center, Primary Care | $818 |
| 19 | 1982640827 | $548 |
| 20 | 1982680922 | $509 |
Showing top 20 of 31 providers billing this code