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

#1529 of 11K

98960

HCPCS Procedure Code

HCPCS code 98960 is the #1,529 most-billed Medicaid procedure code, with $20.1M in payments across 1.1M claims from 2018–2024. The national median cost per claim is $12.74. Costs vary widely — the 90th percentile is $49.96 per claim, 3.9× the median.

Total Paid

$20.1M

0.00% of all spending

Total Claims

1.1M

Providers

885

Avg Cost/Claim

$19

National Cost Distribution

How much do providers bill per claim for 98960? Based on 583 providers billing this code nationally.

Median

$12.74

Average

$24.47

Std Dev

$45.10

Max

$654.80

Percentile Distribution (Cost per Claim)

p10
$0.48
p25
$2.53
Median
$12.74
p75
$32.86
p90
$49.96
p95
$71.95
p99
$159.84

50% of providers bill between $2.53 and $32.86 per claim for this code.

90% bill between $0.48 and $49.96.

Top 1% bill above $159.84.

About This Procedure

HCPCS code 98960 was billed by 885 providers across 1.1M claims, totaling $20.1M in Medicaid payments from 2018–2024. This code was used for 674K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$12.74

Providers Billing

583

National Spending

$20.1M

Avg/Median Ratio

1.92×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for 98960

#ProviderTotal Paid
11821042086$1.0M
21437656840$832K
31275232993$742K
41053189514$714K
51578508453$649K
61891407235$571K
71689225351$544K
81528848934$537K
91760193858$532K
101306557491$513K
111235843608$512K
121477332880$480K
131114656816$443K
141962276980$408K
151144405762$360K
161063030419$357K
171619687373$308K
181073620498$296K
191245731173$295K
201083013619$289K

Showing top 20 of 885 providers billing this code