96103
HCPCS Procedure Code
HCPCS code 96103 is the #4,150 most-billed Medicaid procedure code, with $804K in payments across 73K claims from 2018–2024. The national median cost per claim is $5.95. Costs vary widely — the 90th percentile is $17.03 per claim, 2.9× the median.
Total Paid
$804K
0.00% of all spending
Total Claims
73K
Providers
221
Avg Cost/Claim
$11
National Cost Distribution
How much do providers bill per claim for 96103? Based on 176 providers billing this code nationally.
Median
$5.95
Average
$9.85
Std Dev
$18.55
Max
$193.02
Percentile Distribution (Cost per Claim)
50% of providers bill between $1.66 and $11.81 per claim for this code.
90% bill between $0.63 and $17.03.
Top 1% bill above $79.10.
About This Procedure
HCPCS code 96103 was billed by 221 providers across 73K claims, totaling $804K in Medicaid payments from 2018–2024. This code was used for 58K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$5.95
Providers Billing
176
National Spending
$804K
Avg/Median Ratio
1.66×
Moderately skewed
Top Providers Billing This Code
Ranked by total Medicaid payments for 96103
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1932533361 | $317K |
| 2 | 1447244256 | $115K |
| 3 | 1124346986 | $86K |
| 4 | 1619403870 | $47K |
| 5 | 1578754503 | $18K |
| 6 | 1528263647 | $18K |
| 7 | 1306280177 | $12K |
| 8 | 1366806655 | $10K |
| 9 | 1639135387 | $8K |
| 10 | 1902095003 | $7K |
| 11 | 1437565900 | $6K |
| 12 | 1487081758 | $6K |
| 13 | 1760524029 | $6K |
| 14 | 1104854124 | $6K |
| 15 | 1659689222 | $6K |
| 16 | 1629018981 | $5K |
| 17 | 1376967422 | $5K |
| 18 | 1639193212 | $4K |
| 19 | 1003218553 | $4K |
| 20 | 1588804777 | $4K |
Showing top 20 of 221 providers billing this code