97127
HCPCS Procedure Code
HCPCS code 97127 is the #1,692 most-billed Medicaid procedure code, with $16.0M in payments across 170K claims from 2018–2024. The national median cost per claim is $66.78.
Total Paid
$16.0M
0.00% of all spending
Total Claims
170K
Providers
126
Avg Cost/Claim
$94
National Cost Distribution
How much do providers bill per claim for 97127? Based on 112 providers billing this code nationally.
Median
$66.78
Average
$85.48
Std Dev
$143.78
Max
$1,260.10
Percentile Distribution (Cost per Claim)
50% of providers bill between $30.19 and $80.81 per claim for this code.
90% bill between $12.41 and $93.76.
Top 1% bill above $738.61.
About This Procedure
HCPCS code 97127 was billed by 126 providers across 170K claims, totaling $16.0M in Medicaid payments from 2018–2024. This code was used for 38K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$66.78
Providers Billing
112
National Spending
$16.0M
Avg/Median Ratio
1.28×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for 97127
| # | Provider | Total Paid |
|---|---|---|
| 1 | Wall Residences Llc Floyd, VA · Community Based Residential Treatment Facility Intellectual and/or Developmental Disabilities | $2.0M |
| 2 | Bilinguals Inc. Forest Hills, NY · Early Intervention Provider Agency | $1.5M |
| 3 | 1598019721 | $1.3M |
| 4 | 1447651070 | $1.3M |
| 5 | 1992961908 | $1.3M |
| 6 | 1033345186 | $962K |
| 7 | 1053854059 | $631K |
| 8 | 1104118306 | $332K |
| 9 | 1619122959 | $298K |
| 10 | 1447400122 | $276K |
| 11 | 1730137753 | $248K |
| 12 | 1598065096 | $237K |
| 13 | 1447283882 | $228K |
| 14 | 1588719041 | $211K |
| 15 | 1841231461 | $210K |
| 16 | Children's Specialized Hospital New Brunswick, NJ · Pediatrics | $192K |
| 17 | 1568603090 | $192K |
| 18 | 1679920490 | $173K |
| 19 | 1225287758 | $171K |
| 20 | 1053552901 | $161K |
Showing top 20 of 126 providers billing this code