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#1828 of 11K

96920

HCPCS Procedure Code

HCPCS code 96920 is the #1,828 most-billed Medicaid procedure code, with $13.2M in payments across 111K claims from 2018–2024. The national median cost per claim is $118.58.

Total Paid

$13.2M

0.00% of all spending

Total Claims

111K

Providers

68

Avg Cost/Claim

$118

National Cost Distribution

How much do providers bill per claim for 96920? Based on 68 providers billing this code nationally.

Median

$118.58

Average

$122.89

Std Dev

$50.85

Max

$246.57

Percentile Distribution (Cost per Claim)

p10
$58.84
p25
$87.33
Median
$118.58
p75
$153.65
p90
$194.70
p95
$211.99
p99
$229.70

50% of providers bill between $87.33 and $153.65 per claim for this code.

90% bill between $58.84 and $194.70.

Top 1% bill above $229.70.

About This Procedure

HCPCS code 96920 was billed by 68 providers across 111K claims, totaling $13.2M in Medicaid payments from 2018–2024. This code was used for 38K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$118.58

Providers Billing

68

National Spending

$13.2M

Avg/Median Ratio

1.04×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 96920

#ProviderTotal Paid
11629219522$952K
21225309586$708K
31336343268$681K
41780857318$637K
51013994839$612K
61013183961$608K
71164656229$586K
81184027104$531K
91609826163$519K
101184777427$493K
111447220215$454K
121134201460$428K
131265765267$427K
141033457395$369K
151205871001$362K
161609078997$342K
171730165614$293K
18State Of Connecticut

Farmington, CT · Counselor, Professional

$280K
191558573097$278K
201710124417$271K

Showing top 20 of 68 providers billing this code