Statistical flags indicate unusual patterns — not proof of fraud or wrongdoing. Read our methodology

#995 of 11K

96376

HCPCS Procedure Code

HCPCS code 96376 is the #995 most-billed Medicaid procedure code, with $49.5M in payments across 5.6M claims from 2018–2024. The national median cost per claim is $3.19. Costs vary widely — the 90th percentile is $37.00 per claim, 11.6× the median.

Total Paid

$49.5M

0.00% of all spending

Total Claims

5.6M

Providers

2,285

Avg Cost/Claim

$9

National Cost Distribution

How much do providers bill per claim for 96376? Based on 1,930 providers billing this code nationally.

Median

$3.19

Average

$12.97

Std Dev

$27.04

Max

$447.69

Percentile Distribution (Cost per Claim)

p10
$0.09
p25
$0.64
Median
$3.19
p75
$13.79
p90
$37.00
p95
$51.78
p99
$108.98

50% of providers bill between $0.64 and $13.79 per claim for this code.

90% bill between $0.09 and $37.00.

Top 1% bill above $108.98.

About This Procedure

HCPCS code 96376 was billed by 2,285 providers across 5.6M claims, totaling $49.5M in Medicaid payments from 2018–2024. This code was used for 3.6M unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$3.19

Providers Billing

1,930

National Spending

$49.5M

Avg/Median Ratio

4.07×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for 96376

#ProviderTotal Paid
1Pikeville Medical Center Inc

Pikeville, KY · General Acute Care Hospital

$1.3M
2Norton Hospitals Inc

Louisville, KY · General Acute Care Hospital

$1.1M
3Owensboro Health Inc

Owensboro, KY · General Acute Care Hospital

$892K
4University Of Kentucky

Lexington, KY · General Acute Care Hospital

$852K
5Rhode Island Hospital

Providence, RI · General Acute Care Hospital

$773K
6University Hospital

Newark, NJ · General Acute Care Hospital

$730K
7Providence Health & Services Washington

Anchorage, AK · General Acute Care Hospital

$659K
8Uofl Health-louisville Inc

Louisville, KY · Psychiatric Hospital

$596K
91447231956$591K
10Kennedy University Hospital Inc.

Stratford, NJ · General Acute Care Hospital

$558K
111538244918$553K
121427055821$553K
131073518007$548K
141235196510$544K
151356390264$533K
16The Miriam Hospital

Providence, RI · General Acute Care Hospital

$490K
17Ahs Hospital Corp.

Morristown, NJ · General Acute Care Hospital

$488K
181265539498$487K
19St Elizabeth Medical Center, Inc

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

$439K
20Presbyterian Healthcare Services

Albuquerque, NM · Emergency Medicine

$434K

Showing top 20 of 2,285 providers billing this code