97139
HCPCS Procedure Code
HCPCS code 97139 is the #583 most-billed Medicaid procedure code, with $138.9M in payments across 3.7M claims from 2018–2024. The national median cost per claim is $28.71. Costs vary widely — the 90th percentile is $312.35 per claim, 10.9× the median.
Total Paid
$138.9M
0.01% of all spending
Total Claims
3.7M
Providers
484
Avg Cost/Claim
$37
National Cost Distribution
How much do providers bill per claim for 97139? Based on 411 providers billing this code nationally.
Median
$28.71
Average
$98.68
Std Dev
$169.96
Max
$1,444.56
Percentile Distribution (Cost per Claim)
50% of providers bill between $17.32 and $79.90 per claim for this code.
90% bill between $6.34 and $312.35.
Top 1% bill above $785.35.
About This Procedure
HCPCS code 97139 was billed by 484 providers across 3.7M claims, totaling $138.9M in Medicaid payments from 2018–2024. This code was used for 972K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$28.71
Providers Billing
411
National Spending
$138.9M
Avg/Median Ratio
3.44×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for 97139
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1952394603 | $15.7M |
| 2 | 1174898506 | $12.5M |
| 3 | 1013141134 | $11.2M |
| 4 | 1669420980 | $4.3M |
| 5 | 1518121516 | $2.9M |
| 6 | 1396820098 | $2.8M |
| 7 | 1609117829 | $2.5M |
| 8 | 1134255037 | $2.3M |
| 9 | 1215063052 | $2.0M |
| 10 | 1619122348 | $1.9M |
| 11 | 1508016791 | $1.8M |
| 12 | Wall Residences Llc Floyd, VA · Community Based Residential Treatment Facility Intellectual and/or Developmental Disabilities | $1.8M |
| 13 | 1710440268 | $1.7M |
| 14 | County Of Ventura Ventura, CA · Clinic/Center, Emergency Care | $1.7M |
| 15 | 1033832985 | $1.6M |
| 16 | 1467827493 | $1.6M |
| 17 | 1689257354 | $1.5M |
| 18 | 1720159676 | $1.4M |
| 19 | 1568730349 | $1.2M |
| 20 | West Coast Spine Restoration Center Inc Riverside, CA · Physical Therapist | $1.1M |
Showing top 20 of 484 providers billing this code