97113
HCPCS Procedure Code
HCPCS code 97113 is the #834 most-billed Medicaid procedure code, with $70.1M in payments across 1.1M claims from 2018–2024. The national median cost per claim is $51.02.
Total Paid
$70.1M
0.01% of all spending
Total Claims
1.1M
Providers
674
Avg Cost/Claim
$62
National Cost Distribution
How much do providers bill per claim for 97113? Based on 655 providers billing this code nationally.
Median
$51.02
Average
$59.56
Std Dev
$42.60
Max
$458.26
Percentile Distribution (Cost per Claim)
50% of providers bill between $35.53 and $74.73 per claim for this code.
90% bill between $23.33 and $101.46.
Top 1% bill above $199.06.
About This Procedure
HCPCS code 97113 was billed by 674 providers across 1.1M claims, totaling $70.1M in Medicaid payments from 2018–2024. This code was used for 362K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$51.02
Providers Billing
655
National Spending
$70.1M
Avg/Median Ratio
1.17×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for 97113
| # | Provider | Total Paid |
|---|---|---|
| 1 | Ahava Medical And Rehabilitation Center, Llc Brooklyn, NY · Rehabilitation Practitioner | $6.0M |
| 2 | Caregivers Home Health Tx Inc Richardson, TX · Nursing Care | $4.4M |
| 3 | Disability Services Of The Southwest, Inc San Antonio, TX · Day Training, Developmentally Disabled Services | $4.1M |
| 4 | Astrocare Class, Inc. Houston, TX · Home Health | $2.6M |
| 5 | 1528573938 | $1.6M |
| 6 | 1558512327 | $1.4M |
| 7 | 1952394603 | $1.4M |
| 8 | 1316279847 | $1.2M |
| 9 | 1730137753 | $1.0M |
| 10 | 1083647515 | $915K |
| 11 | 1457397531 | $912K |
| 12 | 1407046881 | $865K |
| 13 | 1356482004 | $721K |
| 14 | Rhode Island Hospital Providence, RI · General Acute Care Hospital | $694K |
| 15 | 1700325677 | $672K |
| 16 | 1255354288 | $632K |
| 17 | 1386671378 | $612K |
| 18 | 1033293691 | $609K |
| 19 | 1861717605 | $568K |
| 20 | 1477534089 | $559K |
Showing top 20 of 674 providers billing this code