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#4696 of 11K

P9612

HCPCS Procedure Code

HCPCS code P9612 is the #4,696 most-billed Medicaid procedure code, with $445K in payments across 96K claims from 2018–2024. The national median cost per claim is $1.46. Costs vary widely — the 90th percentile is $20.90 per claim, 14.3× the median.

Total Paid

$445K

0.00% of all spending

Total Claims

96K

Providers

183

Avg Cost/Claim

$5

National Cost Distribution

How much do providers bill per claim for P9612? Based on 132 providers billing this code nationally.

Median

$1.46

Average

$7.69

Std Dev

$16.18

Max

$105.67

Percentile Distribution (Cost per Claim)

p10
$0.03
p25
$0.08
Median
$1.46
p75
$6.18
p90
$20.90
p95
$33.03
p99
$74.00

50% of providers bill between $0.08 and $6.18 per claim for this code.

90% bill between $0.03 and $20.90.

Top 1% bill above $74.00.

About This Procedure

HCPCS code P9612 was billed by 183 providers across 96K claims, totaling $445K in Medicaid payments from 2018–2024. This code was used for 79K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$1.46

Providers Billing

132

National Spending

$445K

Avg/Median Ratio

5.27×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for P9612

#ProviderTotal Paid
11740772268$62K
2University Of Kentucky

Lexington, KY · General Acute Care Hospital

$58K
3Medical University Hospital Authority

Charleston, SC · General Acute Care Hospital

$54K
41053321919$35K
51578547865$31K
6St Elizabeth Medical Center, Inc

Edgewood, KY · Portable X-Ray and/or Other Portable Diagnostic Imaging Supplier

$28K
7Baptist Healthcare System Inc

Corbin, KY · General Acute Care Hospital

$23K
81689628232$14K
91851396394$11K
101538244918$11K
11St. Mary's Medical Center Inc

Huntington, WV · General Acute Care Hospital

$10K
121811213994$9K
131730264128$8K
141265539498$8K
15Owensboro Health Inc

Owensboro, KY · General Acute Care Hospital

$7K
161447296249$6K
171457389249$5K
181154419737$5K
191386720183$4K
201558313213$3K

Showing top 20 of 183 providers billing this code