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#3522 of 11K

C1726

HCPCS Procedure Code

HCPCS code C1726 is the #3,522 most-billed Medicaid procedure code, with $1.6M in payments across 48K claims from 2018–2024. The national median cost per claim is $27.12. Costs vary widely — the 90th percentile is $213.88 per claim, 7.9× the median.

Total Paid

$1.6M

0.00% of all spending

Total Claims

48K

Providers

167

Avg Cost/Claim

$33

National Cost Distribution

How much do providers bill per claim for C1726? Based on 79 providers billing this code nationally.

Median

$27.12

Average

$73.45

Std Dev

$93.24

Max

$438.60

Percentile Distribution (Cost per Claim)

p10
$0.61
p25
$2.14
Median
$27.12
p75
$114.66
p90
$213.88
p95
$250.83
p99
$334.11

50% of providers bill between $2.14 and $114.66 per claim for this code.

90% bill between $0.61 and $213.88.

Top 1% bill above $334.11.

About This Procedure

HCPCS code C1726 was billed by 167 providers across 48K claims, totaling $1.6M in Medicaid payments from 2018–2024. This code was used for 41K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$27.12

Providers Billing

79

National Spending

$1.6M

Avg/Median Ratio

2.71×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for C1726

#ProviderTotal Paid
1University Of Kentucky

Lexington, KY · General Acute Care Hospital

$574K
2Norton Hospitals, Inc

Louisville, KY · General Acute Care Hospital

$153K
3Norton Hospitals Inc

Louisville, KY · General Acute Care Hospital

$121K
4Nyu Langone Hospitals

New York, NY · Clinic/Center, Oncology

$76K
5Montefiore Medical Center

Bronx, NY · General Acute Care Hospital

$66K
6Banner - University Medical Center Phoenix

Phoenix, AZ · Clinic/Center, Sleep Disorder Diagnostic

$66K
71407805971$46K
8Banner - University Medical Center Tucson Campus Llc

Tucson, AZ · Clinic/Center, Multi-Specialty

$46K
9University Of California Irvine

Orange, CA · General Acute Care Hospital

$38K
10Unm Hospital

Albuquerque, NM · General Acute Care Hospital

$37K
11Maimonides Medical Center

Brooklyn, NY · General Acute Care Hospital

$33K
121689282147$32K
13Arthur G James Cancer Hospital And Research Institute

Columbus, OH · Special Hospital

$32K
141699874248$23K
15Phoenix Children's Hospital

Phoenix, AZ · General Acute Care Hospital Children

$20K
161235212721$16K
17Uofl Health-louisville Inc

Louisville, KY · Psychiatric Hospital

$13K
18The Cooper Health System

Camden, NJ · General Acute Care Hospital

$12K
19Virginia Commonwealth University Health System Authority

Richmond, VA · General Acute Care Hospital

$11K
20Charleston Area Medical Center Inc

Charleston, WV · General Acute Care Hospital

$11K

Showing top 20 of 167 providers billing this code