97598
HCPCS Procedure Code
HCPCS code 97598 is the #2,925 most-billed Medicaid procedure code, with $3.0M in payments across 32K claims from 2018–2024. The national median cost per claim is $35.30. Costs vary widely — the 90th percentile is $225.20 per claim, 6.4× the median.
Total Paid
$3.0M
0.00% of all spending
Total Claims
32K
Providers
70
Avg Cost/Claim
$95
National Cost Distribution
How much do providers bill per claim for 97598? Based on 59 providers billing this code nationally.
Median
$35.30
Average
$80.01
Std Dev
$114.27
Max
$594.17
Percentile Distribution (Cost per Claim)
50% of providers bill between $16.36 and $82.58 per claim for this code.
90% bill between $8.09 and $225.20.
Top 1% bill above $505.45.
About This Procedure
HCPCS code 97598 was billed by 70 providers across 32K claims, totaling $3.0M in Medicaid payments from 2018–2024. This code was used for 14K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$35.30
Providers Billing
59
National Spending
$3.0M
Avg/Median Ratio
2.27×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for 97598
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1194762294 | $798K |
| 2 | 1013013002 | $401K |
| 3 | 1316938301 | $397K |
| 4 | Riverside Hospital Inc Newport News, VA · Psychiatric Hospital | $379K |
| 5 | 1083340558 | $201K |
| 6 | 1811957681 | $158K |
| 7 | 1437269255 | $148K |
| 8 | Regents Of The University Of California San Diego, CA · General Acute Care Hospital | $146K |
| 9 | District Hospital Partners L P Washington, DC · Nurse Practitioner, Family | $49K |
| 10 | 1396990545 | $48K |
| 11 | 1578949889 | $37K |
| 12 | 1649498015 | $32K |
| 13 | 1598868655 | $27K |
| 14 | 1205089026 | $24K |
| 15 | 1134297393 | $22K |
| 16 | 1356528269 | $17K |
| 17 | 1831115641 | $14K |
| 18 | Holzer Hospital Foundation Gallipolis, OH · General Acute Care Hospital Rural | $13K |
| 19 | 1710020623 | $13K |
| 20 | 1699861013 | $13K |
Showing top 20 of 70 providers billing this code