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

#4557 of 11K

96912

HCPCS Procedure Code

HCPCS code 96912 is the #4,557 most-billed Medicaid procedure code, with $515K in payments across 26K claims from 2018–2024. The national median cost per claim is $34.84. Costs vary widely — the 90th percentile is $82.11 per claim, 2.4× the median.

Total Paid

$515K

0.00% of all spending

Total Claims

26K

Providers

6

Avg Cost/Claim

$20

National Cost Distribution

How much do providers bill per claim for 96912? Based on 6 providers billing this code nationally.

Median

$34.84

Average

$43.98

Std Dev

$34.15

Max

$104.72

Percentile Distribution (Cost per Claim)

p10
$15.00
p25
$19.30
Median
$34.84
p75
$54.63
p90
$82.11
p95
$93.41
p99
$102.46

50% of providers bill between $19.30 and $54.63 per claim for this code.

90% bill between $15.00 and $82.11.

Top 1% bill above $102.46.

About This Procedure

HCPCS code 96912 was billed by 6 providers across 26K claims, totaling $515K in Medicaid payments from 2018–2024. This code was used for 16K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$34.84

Providers Billing

6

National Spending

$515K

Avg/Median Ratio

1.26×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 96912

#ProviderTotal Paid
11568873727$296K
21811135247$103K
31154407856$81K
41497716609$34K
51821285974$1K
61164408282$475

Showing top 6 of 6 providers billing this code