97533
HCPCS Procedure Code
HCPCS code 97533 is the #554 most-billed Medicaid procedure code, with $148.7M in payments across 2.9M claims from 2018–2024. The national median cost per claim is $48.71. Costs vary widely — the 90th percentile is $107.11 per claim, 2.2× the median.
Total Paid
$148.7M
0.01% of all spending
Total Claims
2.9M
Providers
770
Avg Cost/Claim
$52
National Cost Distribution
How much do providers bill per claim for 97533? Based on 729 providers billing this code nationally.
Median
$48.71
Average
$57.96
Std Dev
$47.42
Max
$622.63
Percentile Distribution (Cost per Claim)
50% of providers bill between $29.07 and $76.17 per claim for this code.
90% bill between $16.04 and $107.11.
Top 1% bill above $214.48.
About This Procedure
HCPCS code 97533 was billed by 770 providers across 2.9M claims, totaling $148.7M in Medicaid payments from 2018–2024. This code was used for 836K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$48.71
Providers Billing
729
National Spending
$148.7M
Avg/Median Ratio
1.19×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for 97533
| # | Provider | Total Paid |
|---|---|---|
| 1 | City Of New York Brooklyn, NY · Local Education Agency (LEA) | $12.9M |
| 2 | 1205228343 | $12.3M |
| 3 | 1881835635 | $11.0M |
| 4 | Nyc Department Of Education New York, NY · Local Education Agency (LEA) | $5.6M |
| 5 | 1891841862 | $4.0M |
| 6 | 1629002936 | $3.9M |
| 7 | New York Network Ipa Inc Brooklyn, NY · Exclusive Provider Organization | $2.3M |
| 8 | 1831441054 | $2.2M |
| 9 | 1487031902 | $2.0M |
| 10 | 1467506691 | $1.9M |
| 11 | 1932343787 | $1.9M |
| 12 | 1992096291 | $1.7M |
| 13 | 1164184271 | $1.7M |
| 14 | 1922568567 | $1.6M |
| 15 | 1306244736 | $1.4M |
| 16 | 1083210686 | $1.3M |
| 17 | 1467604694 | $1.2M |
| 18 | Commonwealth Of Pennsylvania Department Of Education West Hazleton, PA · Local Education Agency (LEA) | $1.2M |
| 19 | 1124434261 | $1.1M |
| 20 | 1760586978 | $1.1M |
Showing top 20 of 770 providers billing this code