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#7186 of 11K

98970

HCPCS Procedure Code

HCPCS code 98970 is the #7,186 most-billed Medicaid procedure code, with $26K in payments across 9,348 claims from 2018–2024. The national median cost per claim is $2.16. Costs vary widely — the 90th percentile is $8.75 per claim, 4.1× the median.

Total Paid

$26K

0.00% of all spending

Total Claims

9,348

Providers

26

Avg Cost/Claim

$3

National Cost Distribution

How much do providers bill per claim for 98970? Based on 16 providers billing this code nationally.

Median

$2.16

Average

$4.56

Std Dev

$6.07

Max

$24.55

Percentile Distribution (Cost per Claim)

p10
$0.26
p25
$1.31
Median
$2.16
p75
$5.41
p90
$8.75
p95
$13.82
p99
$22.40

50% of providers bill between $1.31 and $5.41 per claim for this code.

90% bill between $0.26 and $8.75.

Top 1% bill above $22.40.

About This Procedure

HCPCS code 98970 was billed by 26 providers across 9,348 claims, totaling $26K in Medicaid payments from 2018–2024. This code was used for 7,487 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$2.16

Providers Billing

16

National Spending

$26K

Avg/Median Ratio

2.11×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for 98970

#ProviderTotal Paid
11386107928$11K
2Kaiser Foundation Health Plan Of The Northwest

Portland, OR · General Practice

$6K
3Jersey City Medical Center

Jersey City, NJ · General Acute Care Hospital

$4K
41144527003$2K
51861085318$852
61841812310$742
71083350649$562
81548332455$370
91760614655$310
101407805500$123
111083717219$75
121255471827$37
131255316675$25
141447920798$16
151770854473$13
161144589193$11
171962032003$0
181346494788$0
191265648984$0
201205013190$0

Showing top 20 of 26 providers billing this code