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#6519 of 11K

97607

HCPCS Procedure Code

HCPCS code 97607 is the #6,519 most-billed Medicaid procedure code, with $59K in payments across 2,900 claims from 2018–2024. The national median cost per claim is $8.52. Costs vary widely — the 90th percentile is $77.71 per claim, 9.1× the median.

Total Paid

$59K

0.00% of all spending

Total Claims

2,900

Providers

7

Avg Cost/Claim

$20

National Cost Distribution

How much do providers bill per claim for 97607? Based on 7 providers billing this code nationally.

Median

$8.52

Average

$27.99

Std Dev

$35.74

Max

$89.07

Percentile Distribution (Cost per Claim)

p10
$5.65
p25
$7.89
Median
$8.52
p75
$39.88
p90
$77.71
p95
$83.39
p99
$87.94

50% of providers bill between $7.89 and $39.88 per claim for this code.

90% bill between $5.65 and $77.71.

Top 1% bill above $87.94.

About This Procedure

HCPCS code 97607 was billed by 7 providers across 2,900 claims, totaling $59K in Medicaid payments from 2018–2024. This code was used for 917 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$8.52

Providers Billing

7

National Spending

$59K

Avg/Median Ratio

3.29×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for 97607

#ProviderTotal Paid
11952309098$22K
21104867167$18K
31821424789$10K
41699225029$8K
5Lsu Health Sciences Center Shreveport Faculty Group Practice

Shreveport, LA · Oral & Maxillofacial Surgery

$135
61811398811$126
71578569885$124

Showing top 7 of 7 providers billing this code