96170
HCPCS Procedure Code
HCPCS code 96170 is the #4,194 most-billed Medicaid procedure code, with $763K in payments across 21K claims from 2018–2024. The national median cost per claim is $41.70. Costs vary widely — the 90th percentile is $101.38 per claim, 2.4× the median.
Total Paid
$763K
0.00% of all spending
Total Claims
21K
Providers
14
Avg Cost/Claim
$36
National Cost Distribution
How much do providers bill per claim for 96170? Based on 12 providers billing this code nationally.
Median
$41.70
Average
$49.18
Std Dev
$30.19
Max
$105.66
Percentile Distribution (Cost per Claim)
50% of providers bill between $34.98 and $52.37 per claim for this code.
90% bill between $21.32 and $101.38.
Top 1% bill above $105.54.
About This Procedure
HCPCS code 96170 was billed by 14 providers across 21K claims, totaling $763K in Medicaid payments from 2018–2024. This code was used for 4,698 unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$41.70
Providers Billing
12
National Spending
$763K
Avg/Median Ratio
1.18×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for 96170
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1952781411 | $446K |
| 2 | 1437759107 | $97K |
| 3 | 1538734637 | $86K |
| 4 | 1114473220 | $69K |
| 5 | 1265915805 | $30K |
| 6 | 1134764376 | $22K |
| 7 | 1972757904 | $6K |
| 8 | 1851325906 | $3K |
| 9 | 1780800128 | $2K |
| 10 | 1841573375 | $1K |
| 11 | Phoenix Children's Hospital Phoenix, AZ · Pediatrics | $937 |
| 12 | 1124557426 | $602 |
| 13 | 1336245828 | $0 |
| 14 | Mountain Park Health Center Phoenix, AZ · Clinic/Center, Federally Qualified Health Center (FQHC) | $0 |
Showing top 14 of 14 providers billing this code