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#3691 of 11K

D9997

HCPCS Procedure Code

HCPCS code D9997 is the #3,691 most-billed Medicaid procedure code, with $1.3M in payments across 23K claims from 2018–2024. The national median cost per claim is $33.57. Costs vary widely — the 90th percentile is $82.60 per claim, 2.5× the median.

Total Paid

$1.3M

0.00% of all spending

Total Claims

23K

Providers

60

Avg Cost/Claim

$59

National Cost Distribution

How much do providers bill per claim for D9997? Based on 33 providers billing this code nationally.

Median

$33.57

Average

$47.35

Std Dev

$46.67

Max

$224.63

Percentile Distribution (Cost per Claim)

p10
$6.55
p25
$26.77
Median
$33.57
p75
$54.63
p90
$82.60
p95
$148.52
p99
$200.71

50% of providers bill between $26.77 and $54.63 per claim for this code.

90% bill between $6.55 and $82.60.

Top 1% bill above $200.71.

About This Procedure

HCPCS code D9997 was billed by 60 providers across 23K claims, totaling $1.3M in Medicaid payments from 2018–2024. This code was used for 16K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$33.57

Providers Billing

33

National Spending

$1.3M

Avg/Median Ratio

1.41×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for D9997

#ProviderTotal Paid
11972982007$739K
21043663107$179K
31982674917$88K
41760436190$64K
5Mary Imogene Bassett Hospital

Cooperstown, NY · General Acute Care Hospital, Rural

$59K
61578529954$40K
7Montefiore Medical Center

Bronx, NY · General Acute Care Hospital

$30K
81508812116$24K
91568509149$15K
101326519612$14K
11Department Of Intellectual And Developmental Disabilities, State Of Tn

Nashville, TN · Public Health or Welfare

$12K
12Department Of Intellectual And Developmental Disabilities, State Of Tn

Nashville, TN · Public Health or Welfare

$9K
13University Of Rochester

Rochester, NY · General Acute Care Hospital

$9K
141073689600$8K
151932167145$8K
161699805390$6K
171699895706$5K
181780702167$3K
191982787537$2K
201598299356$2K

Showing top 20 of 60 providers billing this code