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#2182 of 11K

96523

HCPCS Procedure Code

HCPCS code 96523 is the #2,182 most-billed Medicaid procedure code, with $8.1M in payments across 275K claims from 2018–2024. The national median cost per claim is $19.90. Costs vary widely — the 90th percentile is $56.21 per claim, 2.8× the median.

Total Paid

$8.1M

0.00% of all spending

Total Claims

275K

Providers

469

Avg Cost/Claim

$30

National Cost Distribution

How much do providers bill per claim for 96523? Based on 452 providers billing this code nationally.

Median

$19.90

Average

$28.26

Std Dev

$28.95

Max

$259.30

Percentile Distribution (Cost per Claim)

p10
$4.77
p25
$12.49
Median
$19.90
p75
$36.48
p90
$56.21
p95
$71.30
p99
$146.70

50% of providers bill between $12.49 and $36.48 per claim for this code.

90% bill between $4.77 and $56.21.

Top 1% bill above $146.70.

About This Procedure

HCPCS code 96523 was billed by 469 providers across 275K claims, totaling $8.1M in Medicaid payments from 2018–2024. This code was used for 192K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$19.90

Providers Billing

452

National Spending

$8.1M

Avg/Median Ratio

1.42×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 96523

#ProviderTotal Paid
1Medical University Hospital Authority

Charleston, SC · General Acute Care Hospital

$313K
2The Cooper Health System

Camden, NJ · General Acute Care Hospital

$303K
3Spartanburg Medical Center

Spartanburg, SC · Ambulance

$276K
4Long Island Jewish Medical Center

New Hyde Park, NY · General Acute Care Hospital

$268K
51699756221$241K
6State Of Mississippi - University Of Mississippi Medical Center

Jackson, MS · General Acute Care Hospital

$238K
71376624981$233K
8Virginia Commonwealth University Health System Authority

Richmond, VA · General Acute Care Hospital

$160K
91982604021$144K
10Baystate Medical Center Inc

Springfield, MA · General Acute Care Hospital

$140K
111679660617$135K
12Regents Of The University Of California

San Diego, CA · General Acute Care Hospital

$127K
13Multicare Health System

Tacoma, WA · Community/Behavioral Health

$122K
14Lee Memorial Health System

Ft Myers, FL · General Acute Care Hospital

$121K
15City Of Hope National Medical Center

Duarte, CA · General Acute Care Hospital

$112K
16Rhode Island Hospital

Providence, RI · General Acute Care Hospital

$111K
171053373480$104K
18Bakersfield Memorial Hospital

Bakersfield, CA · General Acute Care Hospital

$101K
191104859131$99K
20County Of Ventura

Ventura, CA · Clinic/Center, Emergency Care

$98K

Showing top 20 of 469 providers billing this code

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