98942
HCPCS Procedure Code
HCPCS code 98942 is the #904 most-billed Medicaid procedure code, with $60.5M in payments across 2.2M claims from 2018–2024. The national median cost per claim is $28.40.
Total Paid
$60.5M
0.01% of all spending
Total Claims
2.2M
Providers
1K
Avg Cost/Claim
$28
National Cost Distribution
How much do providers bill per claim for 98942? Based on 1K providers billing this code nationally.
Median
$28.40
Average
$29.40
Std Dev
$26.02
Max
$637.82
Percentile Distribution (Cost per Claim)
50% of providers bill between $23.62 and $31.80 per claim for this code.
90% bill between $15.09 and $39.66.
Top 1% bill above $74.30.
About This Procedure
HCPCS code 98942 was billed by 1K providers across 2.2M claims, totaling $60.5M in Medicaid payments from 2018–2024. This code was used for 968K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$28.40
Providers Billing
1K
National Spending
$60.5M
Avg/Median Ratio
1.04×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for 98942
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1477584902 | $2.1M |
| 2 | 1689705964 | $1.8M |
| 3 | 1962578716 | $828K |
| 4 | 1609281310 | $719K |
| 5 | 1609406800 | $671K |
| 6 | 1235384041 | $647K |
| 7 | 1346458643 | $614K |
| 8 | 1972622272 | $608K |
| 9 | 1972512119 | $602K |
| 10 | 1275567422 | $602K |
| 11 | 1619061249 | $551K |
| 12 | 1164600086 | $528K |
| 13 | 1043850290 | $503K |
| 14 | 1427457514 | $473K |
| 15 | 1689758443 | $471K |
| 16 | 1922440684 | $449K |
| 17 | 1649800673 | $440K |
| 18 | 1093095192 | $419K |
| 19 | 1750428058 | $415K |
| 20 | 1538583554 | $410K |
Showing top 20 of 1K providers billing this code