98969
HCPCS Procedure Code
HCPCS code 98969 is the #5,061 most-billed Medicaid procedure code, with $304K in payments across 13K claims from 2018–2024. The national median cost per claim is $34.65. Costs vary widely — the 90th percentile is $175.00 per claim, 5.1× the median.
Total Paid
$304K
0.00% of all spending
Total Claims
13K
Providers
11
Avg Cost/Claim
$24
National Cost Distribution
How much do providers bill per claim for 98969? Based on 8 providers billing this code nationally.
Median
$34.65
Average
$80.99
Std Dev
$78.42
Max
$175.00
Percentile Distribution (Cost per Claim)
50% of providers bill between $21.57 and $175.00 per claim for this code.
90% bill between $15.52 and $175.00.
Top 1% bill above $175.00.
About This Procedure
HCPCS code 98969 was billed by 11 providers across 13K claims, totaling $304K in Medicaid payments from 2018–2024. This code was used for 11K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$34.65
Providers Billing
8
National Spending
$304K
Avg/Median Ratio
2.34×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for 98969
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1669792990 | $221K |
| 2 | 1285864397 | $34K |
| 3 | 1851745657 | $14K |
| 4 | 1649563321 | $11K |
| 5 | 1881964849 | $9K |
| 6 | 1396240768 | $7K |
| 7 | 1174931448 | $5K |
| 8 | 1477959310 | $3K |
| 9 | 1497025910 | $0 |
| 10 | 1649607664 | $0 |
| 11 | 1942478979 | $0 |
Showing top 11 of 11 providers billing this code