#1838 of 11K

94727

HCPCS Procedure Code

HCPCS code 94727 is the #1,838 most-billed Medicaid procedure code, with $13.0M in payments across 596K claims from 2018–2024. The national median cost per claim is $14.31. Costs vary widely — the 90th percentile is $39.73 per claim, 2.8× the median.

Total Paid

$13.0M

0.00% of all spending

Total Claims

596K

Providers

1,149

Avg Cost/Claim

$22

National Cost Distribution

How much do providers bill per claim for 94727? Based on 1,111 providers billing this code nationally.

Median

$14.31

Average

$20.20

Std Dev

$22.58

Max

$250.88

Percentile Distribution (Cost per Claim)

p10

$3.36

p25

$6.61

Median

$14.31

p75

$27.64

p90

$39.73

p95

$52.58

p99

$119.15

50% of providers bill between $6.61 and $27.64 per claim for this code.

90% bill between $3.36 and $39.73.

Top 1% bill above $119.15.

About This Procedure

HCPCS code 94727 was billed by 1,149 providers across 596K claims, totaling $13.0M in Medicaid payments from 2018–2024. This code was used for 554K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$14.31

Providers Billing

1,111

National Spending

$13.0M

Avg/Median Ratio

1.41×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 94727

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1851352678	$627K	$37.71	2.6× median	Above 75th
2	Hmh Hospitals Corporation Hackensack, NJ · Ambulance	$626K	$250.88	17.5× median	Top 1%
3	1639371586	$325K	$35.13	2.5× median	Above 75th
4	Newark Beth Israel Medical Center Inc Newark, NJ · General Acute Care Hospital	$312K	$130.83	9.1× median	Top 1%
5	1790930618	$261K	$27.60	1.9× median	Above Median
6	1780670919	$217K	$36.41	2.5× median	Above 75th
7	Saint Peter's University Hospital New Brunswick, NJ · General Acute Care Hospital	$206K	$46.73	3.3× median	Top 10%
8	1386091486	$186K	$30.08	2.1× median	Above 75th
9	The Lowell General Hospital Lowell, MA · Pharmacy, Institutional Pharmacy	$174K	$45.45	3.2× median	Top 10%
10	1184766107	$166K	$14.42	1.0× median	Above Median
11	1083658918	$166K	$30.86	2.2× median	Above 75th
12	Summa Health System Akron, OH · General Acute Care Hospital	$160K	$64.16	4.5× median	Top 10%
13	Optum Medical Care Of New Jersey Pc Secaucus, NJ · Durable Medical Equipment & Medical Supplies	$160K	$32.94	2.3× median	Above 75th
14	1821097932	$136K	$21.54	1.5× median	Above Median
15	Brockton Hospital, Inc. Brockton, MA · General Acute Care Hospital	$136K	$43.88	3.1× median	Top 10%
16	1710939798	$136K	$27.51	1.9× median	Above Median
17	1356403042	$133K	$31.75	2.2× median	Above 75th
18	North Shore-lij Medical Pc Great Neck, NY · Urology	$121K	$45.24	3.2× median	Top 10%
19	1871606269	$113K	$25.64	1.8× median	Above Median
20	1740252295	$110K	$28.21	2.0× median	Above 75th

Showing top 20 of 1,149 providers billing this code

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94729$46.6M 94726$36.2M 94728$1.6M

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