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#4175 of 11K

D9613

HCPCS Procedure Code

HCPCS code D9613 is the #4,175 most-billed Medicaid procedure code, with $783K in payments across 12K claims from 2018–2024. The national median cost per claim is $55.79. Costs vary widely — the 90th percentile is $191.76 per claim, 3.4× the median.

Total Paid

$783K

0.00% of all spending

Total Claims

12K

Providers

18

Avg Cost/Claim

$66

National Cost Distribution

How much do providers bill per claim for D9613? Based on 15 providers billing this code nationally.

Median

$55.79

Average

$97.99

Std Dev

$83.61

Max

$200.97

Percentile Distribution (Cost per Claim)

p10
$7.92
p25
$25.00
Median
$55.79
p75
$187.44
p90
$191.76
p95
$195.11
p99
$199.80

50% of providers bill between $25.00 and $187.44 per claim for this code.

90% bill between $7.92 and $191.76.

Top 1% bill above $199.80.

About This Procedure

HCPCS code D9613 was billed by 18 providers across 12K claims, totaling $783K in Medicaid payments from 2018–2024. This code was used for 7,133 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$55.79

Providers Billing

15

National Spending

$783K

Avg/Median Ratio

1.76×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for D9613

#ProviderTotal Paid
11295752194$221K
21992122956$198K
31033531124$101K
41053951350$99K
51427563956$46K
61427219245$39K
71457578239$36K
81972554186$12K
91811387863$9K
101225624596$8K
111952898025$4K
121295271450$4K
131154864106$3K
141730253949$2K
151003023029$540
161861913022$0
171669541231$0
181568715175$0

Showing top 18 of 18 providers billing this code

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