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#1162 of 11K

94726

HCPCS Procedure Code

HCPCS code 94726 is the #1,162 most-billed Medicaid procedure code, with $36.2M in payments across 1.3M claims from 2018–2024. The national median cost per claim is $13.41. Costs vary widely — the 90th percentile is $58.35 per claim, 4.4× the median.

Total Paid

$36.2M

0.00% of all spending

Total Claims

1.3M

Providers

2,597

Avg Cost/Claim

$27

National Cost Distribution

How much do providers bill per claim for 94726? Based on 2,522 providers billing this code nationally.

Median

$13.41

Average

$25.28

Std Dev

$31.53

Max

$416.25

Percentile Distribution (Cost per Claim)

p10
$4.24
p25
$6.72
Median
$13.41
p75
$33.04
p90
$58.35
p95
$78.34
p99
$144.67

50% of providers bill between $6.72 and $33.04 per claim for this code.

90% bill between $4.24 and $58.35.

Top 1% bill above $144.67.

About This Procedure

HCPCS code 94726 was billed by 2,597 providers across 1.3M claims, totaling $36.2M in Medicaid payments from 2018–2024. This code was used for 1.2M unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$13.41

Providers Billing

2,522

National Spending

$36.2M

Avg/Median Ratio

1.89×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for 94726

#ProviderTotal Paid
1State Of Mississippi - University Of Mississippi Medical Center

Jackson, MS · General Acute Care Hospital

$589K
2University Of Kentucky

Lexington, KY · General Acute Care Hospital

$501K
31780635078$380K
41851352678$357K
5Boston Medical Center Corporation

Boston, MA · General Acute Care Hospital

$335K
6The Cooper Health System

Camden, NJ · General Acute Care Hospital

$331K
7Pikeville Medical Center Inc

Pikeville, KY · General Acute Care Hospital

$298K
8Saint Mary's Hospital, Inc.

Waterbury, CT · General Acute Care Hospital

$287K
9Childrens Hospital Of Los Angeles

Los Angeles, CA · Case Manager/Care Coordinator

$279K
10Montefiore Medical Center

Bronx, NY · General Acute Care Hospital

$263K
11Regents Of The University Of California

San Diego, CA · General Acute Care Hospital

$255K
12Stamford Hospital

Stamford, CT · Hospitalist

$253K
13Baystate Medical Center Inc

Springfield, MA · General Acute Care Hospital

$253K
141033244348$247K
15New York University

Boynton Beach, FL · Anesthesiology

$234K
161639172372$233K
171629511886$233K
18St Elizabeth Medical Center, Inc

Edgewood, KY · Portable X-Ray and/or Other Portable Diagnostic Imaging Supplier

$223K
19Virginia Commonwealth University Health System Authority

Richmond, VA · General Acute Care Hospital

$210K
20Nyu Langone Hospitals

New York, NY · Clinic/Center, Oncology

$202K

Showing top 20 of 2,597 providers billing this code