#3048 of 11K

97755

HCPCS Procedure Code

HCPCS code 97755 is the #3,048 most-billed Medicaid procedure code, with $2.7M in payments across 26K claims from 2018–2024. The national median cost per claim is $91.92. Costs vary widely — the 90th percentile is $223.28 per claim, 2.4× the median.

Total Paid

$2.7M

0.00% of all spending

Total Claims

26K

Providers

Avg Cost/Claim

$104

National Cost Distribution

How much do providers bill per claim for 97755? Based on 35 providers billing this code nationally.

Median

$91.92

Average

$105.01

Std Dev

$93.19

Max

$374.16

Percentile Distribution (Cost per Claim)

p10

$9.80

p25

$28.05

Median

$91.92

p75

$157.20

p90

$223.28

p95

$263.21

p99

$360.81

50% of providers bill between $28.05 and $157.20 per claim for this code.

90% bill between $9.80 and $223.28.

Top 1% bill above $360.81.

About This Procedure

HCPCS code 97755 was billed by 37 providers across 26K claims, totaling $2.7M in Medicaid payments from 2018–2024. This code was used for 20K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$91.92

Providers Billing

National Spending

$2.7M

Avg/Median Ratio

1.14×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 97755

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	Children's Hospital Medical Center Cincinnati, OH · Clinic/Center, Primary Care	$407K	$91.92	1.0× median	Above Median
2	Virginia Commonwealth University Health System Authority Richmond, VA · General Acute Care Hospital	$395K	$232.50	2.5× median	Top 10%
3	1689656183	$381K	$110.56	1.2× median	Above Median
4	1992205249	$332K	$155.81	1.7× median	Above Median
5	Johns Hopkins All Children's Hospital Inc St Petersburg, FL · General Acute Care Hospital Children	$295K	$226.09	2.5× median	Top 10%
6	1730144593	$270K	$61.74	0.7× median	Below Median
7	1063695351	$111K	$111.48	1.2× median	Above Median
8	1124253760	$107K	$374.16	4.1× median	Top 1%
9	1841258589	$101K	$86.73	0.9× median	Below Median
10	1730781063	$38K	$116.87	1.3× median	Above Median
11	1689910317	$37K	$113.66	1.2× median	Above Median
12	Yale New Haven Hospital New Haven, CT · General Acute Care Hospital	$31K	$13.72	0.1× median	Below Median
13	Children's Specialized Hospital New Brunswick, NJ · Pediatrics	$30K	$169.20	1.8× median	Above 75th
14	1831188275	$19K	$38.69	0.4× median	Below Median
15	Southern Baptist Hospital Of Florida Inc Jacksonville, FL · General Acute Care Hospital	$19K	$216.72	2.4× median	Above 75th
16	1215927470	$18K	$36.22	0.4× median	Below Median
17	District Medical Group, Inc Phoenix, AZ · Anesthesiology	$16K	$74.37	0.8× median	Below Median
18	Childrens Hospital Of The Kings Daughters Inc Norfolk, VA · Social Worker, Clinical	$16K	$219.08	2.4× median	Above 75th
19	1528061827	$10K	$28.84	0.3× median	Below Median
20	1265689053	$7K	$165.69	1.8× median	Above 75th

Showing top 20 of 37 providers billing this code

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