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

#4491 of 11K

96567

HCPCS Procedure Code

HCPCS code 96567 is the #4,491 most-billed Medicaid procedure code, with $553K in payments across 15K claims from 2018–2024. The national median cost per claim is $129.78. Costs vary widely — the 90th percentile is $469.79 per claim, 3.6× the median.

Total Paid

$553K

0.00% of all spending

Total Claims

15K

Providers

5

Avg Cost/Claim

$37

National Cost Distribution

How much do providers bill per claim for 96567? Based on 4 providers billing this code nationally.

Median

$129.78

Average

$223.56

Std Dev

$257.68

Max

$601.96

Percentile Distribution (Cost per Claim)

p10
$52.34
p25
$81.78
Median
$129.78
p75
$271.55
p90
$469.79
p95
$535.88
p99
$588.74

50% of providers bill between $81.78 and $271.55 per claim for this code.

90% bill between $52.34 and $469.79.

Top 1% bill above $588.74.

About This Procedure

HCPCS code 96567 was billed by 5 providers across 15K claims, totaling $553K in Medicaid payments from 2018–2024. This code was used for 11K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$129.78

Providers Billing

4

National Spending

$553K

Avg/Median Ratio

1.72×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for 96567

#ProviderTotal Paid
11568873727$478K
2New York City Health And Hospitals Corporation

Brooklyn, NY · Internal Medicine

$61K
31467882332$12K
41215096375$2K
51104871193$0

Showing top 5 of 5 providers billing this code

Related Procedures