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#2766 of 11K

P9603

HCPCS Procedure Code

HCPCS code P9603 is the #2,766 most-billed Medicaid procedure code, with $3.8M in payments across 6.3M claims from 2018–2024. The national median cost per claim is $0.33. Costs vary widely — the 90th percentile is $4.23 per claim, 12.8× the median.

Total Paid

$3.8M

0.00% of all spending

Total Claims

6.3M

Providers

353

Avg Cost/Claim

$1

National Cost Distribution

How much do providers bill per claim for P9603? Based on 246 providers billing this code nationally.

Median

$0.33

Average

$1.74

Std Dev

$5.02

Max

$57.82

Percentile Distribution (Cost per Claim)

p10
$0.01
p25
$0.06
Median
$0.33
p75
$1.31
p90
$4.23
p95
$6.96
p99
$19.04

50% of providers bill between $0.06 and $1.31 per claim for this code.

90% bill between $0.01 and $4.23.

Top 1% bill above $19.04.

About This Procedure

HCPCS code P9603 was billed by 353 providers across 6.3M claims, totaling $3.8M in Medicaid payments from 2018–2024. This code was used for 3.6M unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$0.33

Providers Billing

246

National Spending

$3.8M

Avg/Median Ratio

5.27×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for P9603

#ProviderTotal Paid
11780001859$607K
21174251185$478K
31790101681$335K
41659373900$308K
51720378524$240K
6Centers Lab Nj Llc

Cedar Knolls, NJ · Clinical Medical Laboratory

$180K
71447345830$173K
81760414221$114K
91598106163$110K
101669808853$108K
111093756157$99K
121609963834$56K
131154515377$52K
141801523212$51K
151033281324$44K
161952516916$40K
171740361690$38K
18Dx Solutions, Llc

Nicholasville, KY · Clinical Medical Laboratory

$38K
191528653334$37K
201659322360$33K

Showing top 20 of 353 providers billing this code

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