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#4609 of 11K

96380

HCPCS Procedure Code

HCPCS code 96380 is the #4,609 most-billed Medicaid procedure code, with $489K in payments across 47K claims from 2018–2024. The national median cost per claim is $16.33.

Total Paid

$489K

0.00% of all spending

Total Claims

47K

Providers

611

Avg Cost/Claim

$10

National Cost Distribution

How much do providers bill per claim for 96380? Based on 525 providers billing this code nationally.

Median

$16.33

Average

$15.23

Std Dev

$6.76

Max

$66.25

Percentile Distribution (Cost per Claim)

p10
$5.70
p25
$11.36
Median
$16.33
p75
$19.09
p90
$21.17
p95
$23.10
p99
$35.14

50% of providers bill between $11.36 and $19.09 per claim for this code.

90% bill between $5.70 and $21.17.

Top 1% bill above $35.14.

About This Procedure

HCPCS code 96380 was billed by 611 providers across 47K claims, totaling $489K in Medicaid payments from 2018–2024. This code was used for 44K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$16.33

Providers Billing

525

National Spending

$489K

Avg/Median Ratio

0.93×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 96380

#ProviderTotal Paid
1Cook Children's Physician Network

Fort Worth, TX · Medical Genetics, Clinical Genetics (M.D.)

$25K
2Topcare Medical Group Inc

Dallas, TX · Pediatrics

$11K
31477742807$9K
41417004003$9K
5Henry Ford Health System

Detroit, MI · General Acute Care Hospital

$8K
6Spectrum Health Primary Care Partners

Grand Rapids, MI · Psychologist, Clinical Child & Adolescent

$8K
71508859729$7K
8New York City Health And Hospitals Corporation

Brooklyn, NY · Internal Medicine

$6K
91144744301$6K
10New York City Health And Hospitals Corporation

Bronx, NY · Internal Medicine

$6K
11Saltzman Tanis Pittell Levin And Jacobson

Hollywood, FL · Pediatrics

$6K
121164471116$5K
131952320061$5K
14Vanderbilt University Medical Center

Nashville, TN · Transplant Surgery

$5K
151225498231$5K
16Regents Of The University Of Michigan

Ann Arbor, MI · Clinic/Center, End-Stage Renal Disease (ESRD) Treatment

$5K
17Carolinas Medical Center

Charlotte, NC · General Acute Care Hospital

$4K
18Wakemed

Raleigh, NC · General Acute Care Hospital

$4K
19New York City Health And Hospitals Corporation

New York, NY · Internal Medicine

$4K
201326695255$4K

Showing top 20 of 611 providers billing this code