97004
HCPCS Procedure Code
HCPCS code 97004 is the #5,538 most-billed Medicaid procedure code, with $180K in payments across 2K claims from 2018–2024. The national median cost per claim is $84.65.
Total Paid
$180K
0.00% of all spending
Total Claims
2K
Providers
27
Avg Cost/Claim
$74
National Cost Distribution
How much do providers bill per claim for 97004? Based on 25 providers billing this code nationally.
Median
$84.65
Average
$83.46
Std Dev
$5.93
Max
$84.65
Percentile Distribution (Cost per Claim)
50% of providers bill between $84.65 and $84.65 per claim for this code.
90% bill between $84.65 and $84.65.
Top 1% bill above $84.65.
About This Procedure
HCPCS code 97004 was billed by 27 providers across 2K claims, totaling $180K in Medicaid payments from 2018–2024. This code was used for 2K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$84.65
Providers Billing
25
National Spending
$180K
Avg/Median Ratio
0.99×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for 97004
| # | Provider | Total Paid |
|---|---|---|
| 1 | Los Angeles Unified School District Los Angeles, CA · Social Worker School | $40K |
| 2 | 1497897292 | $32K |
| 3 | 1477601052 | $15K |
| 4 | 1588709869 | $13K |
| 5 | 1639395346 | $10K |
| 6 | 1205013752 | $9K |
| 7 | 1033275250 | $9K |
| 8 | 1871773762 | $7K |
| 9 | 1205968088 | $6K |
| 10 | 1396938155 | $6K |
| 11 | 1699979153 | $6K |
| 12 | 1992845457 | $5K |
| 13 | 1295959591 | $3K |
| 14 | 1184764599 | $2K |
| 15 | 1851476931 | $2K |
| 16 | 1962698845 | $2K |
| 17 | 1609945492 | $2K |
| 18 | 1447395728 | $2K |
| 19 | 1669688263 | $2K |
| 20 | 1134254584 | $2K |
Showing top 20 of 27 providers billing this code