97597
HCPCS Procedure Code
HCPCS code 97597 is the #868 most-billed Medicaid procedure code, with $65.4M in payments across 1.4M claims from 2018–2024. The national median cost per claim is $21.22. Costs vary widely — the 90th percentile is $80.37 per claim, 3.8× the median.
Total Paid
$65.4M
0.01% of all spending
Total Claims
1.4M
Providers
1,941
Avg Cost/Claim
$47
National Cost Distribution
How much do providers bill per claim for 97597? Based on 1,887 providers billing this code nationally.
Median
$21.22
Average
$36.70
Std Dev
$48.19
Max
$555.63
Percentile Distribution (Cost per Claim)
50% of providers bill between $11.42 and $44.97 per claim for this code.
90% bill between $5.72 and $80.37.
Top 1% bill above $253.73.
About This Procedure
HCPCS code 97597 was billed by 1,941 providers across 1.4M claims, totaling $65.4M in Medicaid payments from 2018–2024. This code was used for 710K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$21.22
Providers Billing
1,887
National Spending
$65.4M
Avg/Median Ratio
1.73×
Moderately skewed
Top Providers Billing This Code
Ranked by total Medicaid payments for 97597
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1962601393 | $6.0M |
| 2 | 1518309368 | $4.8M |
| 3 | 1699968669 | $2.5M |
| 4 | 1013013002 | $1.1M |
| 5 | District Hospital Partners L P Washington, DC · Nurse Practitioner, Family | $1.1M |
| 6 | Hartford Hospital Hartford, CT · General Acute Care Hospital | $917K |
| 7 | 1336538925 | $872K |
| 8 | Unm Hospital Albuquerque, NM · General Acute Care Hospital | $827K |
| 9 | 1982002283 | $797K |
| 10 | 1346244126 | $733K |
| 11 | 1821093402 | $656K |
| 12 | Providence Health & Services Washington Anchorage, AK · General Acute Care Hospital | $650K |
| 13 | 1831397041 | $572K |
| 14 | 1659782415 | $541K |
| 15 | 1316938301 | $532K |
| 16 | 1649498015 | $515K |
| 17 | 1316394638 | $504K |
| 18 | 1578949889 | $463K |
| 19 | Berkshire Medical Center, Inc Pittsfield, MA · General Acute Care Hospital | $440K |
| 20 | 1518096270 | $419K |
Showing top 20 of 1,941 providers billing this code