#1917 of 11K

96450

HCPCS Procedure Code

HCPCS code 96450 is the #1,917 most-billed Medicaid procedure code, with $11.6M in payments across 45K claims from 2018–2024. The national median cost per claim is $174.39. Costs vary widely — the 90th percentile is $548.46 per claim, 3.1× the median.

Total Paid

$11.6M

0.00% of all spending

Total Claims

45K

Providers

131

Avg Cost/Claim

$255

National Cost Distribution

How much do providers bill per claim for 96450? Based on 130 providers billing this code nationally.

Median

$174.39

Average

$239.35

Std Dev

$206.06

Max

$976.40

Percentile Distribution (Cost per Claim)

p10

$46.29

p25

$90.96

Median

$174.39

p75

$340.94

p90

$548.46

p95

$665.88

p99

$817.22

50% of providers bill between $90.96 and $340.94 per claim for this code.

90% bill between $46.29 and $548.46.

Top 1% bill above $817.22.

About This Procedure

HCPCS code 96450 was billed by 131 providers across 45K claims, totaling $11.6M in Medicaid payments from 2018–2024. This code was used for 36K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$174.39

Providers Billing

130

National Spending

$11.6M

Avg/Median Ratio

1.37×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 96450

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	Scottish Rite Children's Medical Center Atlanta, GA · Pediatrics Pediatric Hematology-Oncology	$2.1M	$613.49	3.5× median	Top 10%
2	Seattle Children's Hospital Seattle, WA · Prosthetic/Orthotic Supplier	$1.1M	$414.22	2.4× median	Above 75th
3	Egleston Children's Hospital At Emory University Inc. Atlanta, GA · Pediatrics Pediatric Emergency Medicine	$864K	$560.77	3.2× median	Top 10%
4	1588862130	$823K	$179.32	1.0× median	Above Median
5	Long Island Jewish Medical Center New Hyde Park, NY · General Acute Care Hospital	$442K	$432.43	2.5× median	Above 75th
6	Nyu Langone Hospitals New York, NY · Clinic/Center, Oncology	$377K	$586.55	3.4× median	Top 10%
7	Ihc Health Services, Inc. Salt Lake City, UT · Psychiatric Unit	$276K	$173.84	1.0× median	Below Median
8	Dana-farber Cancer Institute, Inc. Boston, MA · General Acute Care Hospital	$267K	$672.47	3.9× median	Top 10%
9	Yale New Haven Hospital New Haven, CT · General Acute Care Hospital	$254K	$238.90	1.4× median	Above Median
10	1477503407	$250K	$175.79	1.0× median	Above Median
11	Childrens Hospital Of Los Angeles Los Angeles, CA · Case Manager/Care Coordinator	$236K	$269.91	1.5× median	Above Median
12	Inova Health Care Services Falls Church, VA · Clinic/Center, Rehabilitation, Substance Use Disorder	$235K	$444.58	2.5× median	Above 75th
13	Children's Hospital Of Wisconsin, Inc. Milwaukee, WI · Dentist, Pediatric Dentistry	$227K	$165.57	0.9× median	Below Median
14	Loma Linda University Children's Hospital Loma Linda, CA · General Acute Care Hospital Children	$219K	$260.50	1.5× median	Above Median
15	Phoenix Children's Hospital Phoenix, AZ · General Acute Care Hospital Children	$194K	$65.74	0.4× median	Below Median
16	1811080526	$188K	$104.42	0.6× median	Below Median
17	1306952726	$175K	$382.15	2.2× median	Above 75th
18	Virginia Commonwealth University Health System Authority Richmond, VA · General Acute Care Hospital	$175K	$461.08	2.6× median	Above 75th
19	Childrens Hospital Of The Kings Daughters Inc Norfolk, VA · Social Worker, Clinical	$162K	$524.90	3.0× median	Above 75th
20	Nationwide Children's Hospital Columbus, OH · General Acute Care Hospital	$156K	$415.05	2.4× median	Above 75th

Showing top 20 of 131 providers billing this code

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