96402
HCPCS Procedure Code
HCPCS code 96402 is the #1,697 most-billed Medicaid procedure code, with $15.9M in payments across 262K claims from 2018–2024. The national median cost per claim is $20.95. Costs vary widely — the 90th percentile is $81.11 per claim, 3.9× the median.
Total Paid
$15.9M
0.00% of all spending
Total Claims
262K
Providers
345
Avg Cost/Claim
$61
National Cost Distribution
How much do providers bill per claim for 96402? Based on 330 providers billing this code nationally.
Median
$20.95
Average
$48.08
Std Dev
$113.56
Max
$1,085.85
Percentile Distribution (Cost per Claim)
50% of providers bill between $9.85 and $39.32 per claim for this code.
90% bill between $4.73 and $81.11.
Top 1% bill above $591.99.
About This Procedure
HCPCS code 96402 was billed by 345 providers across 262K claims, totaling $15.9M in Medicaid payments from 2018–2024. This code was used for 224K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$20.95
Providers Billing
330
National Spending
$15.9M
Avg/Median Ratio
2.29×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for 96402
| # | Provider | Total Paid |
|---|---|---|
| 1 | Umass Memorial Medical Center, Inc. Worcester, MA · General Acute Care Hospital | $1.3M |
| 2 | 1699756221 | $1.3M |
| 3 | Boston Medical Center Corporation Boston, MA · General Acute Care Hospital | $1.1M |
| 4 | Hmh Hospitals Corporation Hackensack, NJ · Ambulance | $974K |
| 5 | Spartanburg Medical Center Spartanburg, SC · Ambulance | $767K |
| 6 | Medical University Hospital Authority Charleston, SC · General Acute Care Hospital | $727K |
| 7 | Dana-farber Cancer Institute, Inc. Boston, MA · General Acute Care Hospital | $451K |
| 8 | Arthur G James Cancer Hospital And Research Institute Columbus, OH · Special Hospital | $416K |
| 9 | 1679660617 | $403K |
| 10 | Baystate Medical Center Inc Springfield, MA · General Acute Care Hospital | $387K |
| 11 | 1851361778 | $280K |
| 12 | 1245248939 | $262K |
| 13 | Women & Infants Hospital Of Rhode Island Providence, RI · Clinic/Center, Ambulatory Family Planning Facility | $237K |
| 14 | City Of Hope National Medical Center Duarte, CA · General Acute Care Hospital | $235K |
| 15 | Memorial Hospital For Cancer And Allied Diseases New York, NY · Pharmacy | $235K |
| 16 | 1982604021 | $227K |
| 17 | 1225033020 | $223K |
| 18 | 1780653618 | $203K |
| 19 | The Cooper Health System Camden, NJ · General Acute Care Hospital | $196K |
| 20 | Beth Israel Deaconess Medical Center, Inc. Boston, MA · General Acute Care Hospital | $182K |
Showing top 20 of 345 providers billing this code