#1483 of 11K

D9630

HCPCS Procedure Code

HCPCS code D9630 is the #1,483 most-billed Medicaid procedure code, with $21.7M in payments across 1.0M claims from 2018–2024. The national median cost per claim is $17.78. Costs vary widely — the 90th percentile is $42.00 per claim, 2.4× the median.

Total Paid

$21.7M

0.00% of all spending

Total Claims

1.0M

Providers

695

Avg Cost/Claim

$21

National Cost Distribution

How much do providers bill per claim for D9630? Based on 560 providers billing this code nationally.

Median

$17.78

Average

$20.62

Std Dev

$14.16

Max

$169.41

Percentile Distribution (Cost per Claim)

p10

$8.44

p25

$14.45

Median

$17.78

p75

$22.68

p90

$42.00

p95

$44.00

p99

$45.00

50% of providers bill between $14.45 and $22.68 per claim for this code.

90% bill between $8.44 and $42.00.

Top 1% bill above $45.00.

About This Procedure

HCPCS code D9630 was billed by 695 providers across 1.0M claims, totaling $21.7M in Medicaid payments from 2018–2024. This code was used for 970K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$17.78

Providers Billing

560

National Spending

$21.7M

Avg/Median Ratio

1.16×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for D9630

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1396134185	$1.8M	$44.07	2.5× median	Top 10%
2	1073918835	$1.1M	$43.17	2.4× median	Top 10%
3	1689933582	$684K	$16.49	0.9× median	Below Median
4	1194242859	$683K	$42.17	2.4× median	Top 10%
5	1891158861	$619K	$43.62	2.5× median	Top 10%
6	1982026407	$542K	$44.28	2.5× median	Top 10%
7	1063960649	$540K	$15.06	0.8× median	Below Median
8	1922479047	$521K	$15.75	0.9× median	Below Median
9	1972991248	$494K	$27.20	1.5× median	Above 75th
10	1528603503	$347K	$44.00	2.5× median	Top 10%
11	1275996191	$344K	$44.03	2.5× median	Top 10%
12	1962597815	$322K	$22.57	1.3× median	Above Median
13	1861818668	$291K	$15.27	0.9× median	Below Median
14	1518138320	$284K	$16.39	0.9× median	Below Median
15	1457512188	$280K	$16.34	0.9× median	Below Median
16	1134282981	$269K	$21.78	1.2× median	Above Median
17	1114118130	$261K	$23.94	1.3× median	Above 75th
18	1790086668	$252K	$35.21	2.0× median	Above 75th
19	1487834727	$225K	$15.99	0.9× median	Below Median
20	1851455349	$221K	$19.49	1.1× median	Above Median

Showing top 20 of 695 providers billing this code

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