#2948 of 11K

98927

HCPCS Procedure Code

HCPCS code 98927 is the #2,948 most-billed Medicaid procedure code, with $3.0M in payments across 124K claims from 2018–2024. The national median cost per claim is $25.15. Costs vary widely — the 90th percentile is $50.91 per claim, 2.0× the median.

Total Paid

$3.0M

0.00% of all spending

Total Claims

124K

Providers

267

Avg Cost/Claim

$24

National Cost Distribution

How much do providers bill per claim for 98927? Based on 255 providers billing this code nationally.

Median

$25.15

Average

$27.56

Std Dev

$18.94

Max

$133.74

Percentile Distribution (Cost per Claim)

p10

$4.75

p25

$15.82

Median

$25.15

p75

$34.70

p90

$50.91

p95

$60.60

p99

$84.45

50% of providers bill between $15.82 and $34.70 per claim for this code.

90% bill between $4.75 and $50.91.

Top 1% bill above $84.45.

About This Procedure

HCPCS code 98927 was billed by 267 providers across 124K claims, totaling $3.0M in Medicaid payments from 2018–2024. This code was used for 97K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$25.15

Providers Billing

255

National Spending

$3.0M

Avg/Median Ratio

1.10×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 98927

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1306882261	$246K	$70.43	2.8× median	Top 10%
2	1790074326	$219K	$38.84	1.5× median	Above 75th
3	1083246052	$168K	$29.61	1.2× median	Above Median
4	1801843511	$161K	$82.99	3.3× median	Top 10%
5	1194876136	$156K	$25.73	1.0× median	Above Median
6	1922559558	$132K	$71.02	2.8× median	Top 10%
7	1417031907	$126K	$39.46	1.6× median	Above 75th
8	1629010384	$116K	$25.90	1.0× median	Above Median
9	1215079678	$75K	$47.78	1.9× median	Above 75th
10	The Cleveland Clinic Foundation Cleveland, OH · General Acute Care Hospital	$63K	$29.62	1.2× median	Above Median
11	1154321545	$59K	$14.31	0.6× median	Below Median
12	1326121179	$52K	$27.97	1.1× median	Above Median
13	1316053218	$46K	$16.27	0.6× median	Below Median
14	1144677568	$37K	$20.25	0.8× median	Below Median
15	Mainegeneral Medical Center Augusta, ME · General Acute Care Hospital	$36K	$6.78	0.3× median	Below Median
16	1053357244	$35K	$19.31	0.8× median	Below Median
17	1366606709	$34K	$24.87	1.0× median	Below Median
18	1962953034	$30K	$24.29	1.0× median	Below Median
19	1063720910	$29K	$44.75	1.8× median	Above 75th
20	1548256308	$28K	$17.62	0.7× median	Below Median

Showing top 20 of 267 providers billing this code

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