#1420 of 11K

96910

HCPCS Procedure Code

HCPCS code 96910 is the #1,420 most-billed Medicaid procedure code, with $23.8M in payments across 513K claims from 2018–2024. The national median cost per claim is $51.52.

Total Paid

$23.8M

0.00% of all spending

Total Claims

513K

Providers

176

Avg Cost/Claim

$46

National Cost Distribution

How much do providers bill per claim for 96910? Based on 169 providers billing this code nationally.

Median

$51.52

Average

$55.27

Std Dev

$33.38

Max

$144.32

Percentile Distribution (Cost per Claim)

p10

$15.51

p25

$28.46

Median

$51.52

p75

$77.94

p90

$102.68

p95

$112.20

p99

$136.11

50% of providers bill between $28.46 and $77.94 per claim for this code.

90% bill between $15.51 and $102.68.

Top 1% bill above $136.11.

About This Procedure

HCPCS code 96910 was billed by 176 providers across 513K claims, totaling $23.8M in Medicaid payments from 2018–2024. This code was used for 193K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$51.52

Providers Billing

169

National Spending

$23.8M

Avg/Median Ratio

1.07×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 96910

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1821285974	$3.0M	$28.34	0.5× median	Below Median
2	1336343268	$2.2M	$114.46	2.2× median	Top 10%
3	1134349954	$1.7M	$111.43	2.2× median	Top 10%
4	1780159749	$1.5M	$51.52	1.0× median	Above Median
5	1962426502	$1.0M	$67.91	1.3× median	Above Median
6	1568873727	$786K	$23.93	0.5× median	Below Median
7	1003082090	$774K	$86.41	1.7× median	Above 75th
8	Rhode Island Hospital Providence, RI · General Acute Care Hospital	$606K	$68.86	1.3× median	Above Median
9	1225034234	$484K	$112.71	2.2× median	Top 10%
10	1225309586	$449K	$93.04	1.8× median	Above 75th
11	1184027104	$439K	$14.02	0.3× median	Below Median
12	1891761334	$373K	$95.19	1.8× median	Above 75th
13	1962692152	$369K	$58.63	1.1× median	Above Median
14	1124014741	$369K	$91.04	1.8× median	Above 75th
15	Children's Hospital Of Wisconsin, Inc. Milwaukee, WI · Dentist, Pediatric Dentistry	$366K	$82.23	1.6× median	Above 75th
16	The New York And Presbyterian Hospital New York, NY · General Acute Care Hospital	$345K	$83.71	1.6× median	Above 75th
17	1063782621	$343K	$76.71	1.5× median	Above Median
18	Froedtert Memorial Lutheran Hospital, Inc. Milwaukee, WI · Clinic/Center, Radiology	$336K	$54.88	1.1× median	Above Median
19	Children's Hospital & Research Center At Oakland Oakland, CA · General Acute Care Hospital	$335K	$66.02	1.3× median	Above Median
20	1205871001	$318K	$86.57	1.7× median	Above 75th

Showing top 20 of 176 providers billing this code

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96920$13.2M 96900$4.8M 96912$515K 96913$14K 96902$477

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