Statistical flags indicate unusual patterns — not proof of fraud or wrongdoing. Read our methodology

#3557 of 11K

97610

HCPCS Procedure Code

HCPCS code 97610 is the #3,557 most-billed Medicaid procedure code, with $1.5M in payments across 30K claims from 2018–2024. The national median cost per claim is $17.44. Costs vary widely — the 90th percentile is $92.80 per claim, 5.3× the median.

Total Paid

$1.5M

0.00% of all spending

Total Claims

30K

Providers

54

Avg Cost/Claim

$51

National Cost Distribution

How much do providers bill per claim for 97610? Based on 34 providers billing this code nationally.

Median

$17.44

Average

$42.47

Std Dev

$56.59

Max

$239.63

Percentile Distribution (Cost per Claim)

p10
$0.71
p25
$3.57
Median
$17.44
p75
$63.07
p90
$92.80
p95
$147.18
p99
$229.65

50% of providers bill between $3.57 and $63.07 per claim for this code.

90% bill between $0.71 and $92.80.

Top 1% bill above $229.65.

About This Procedure

HCPCS code 97610 was billed by 54 providers across 30K claims, totaling $1.5M in Medicaid payments from 2018–2024. This code was used for 9,598 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$17.44

Providers Billing

34

National Spending

$1.5M

Avg/Median Ratio

2.44×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for 97610

#ProviderTotal Paid
11649212572$451K
21437675980$329K
31568793750$249K
41306317961$185K
51275969131$100K
61689835563$50K
71720536477$35K
81699975144$29K
91346539640$24K
101407146707$18K
111730144593$14K
121255397840$13K
131376063461$12K
141275869802$11K
151205130911$9K
161447527320$6K
171801447784$5K
181205176096$5K
191760870026$4K
201699225029$4K

Showing top 20 of 54 providers billing this code