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#8046 of 11K

0091A

HCPCS Procedure Code

HCPCS code 0091A is the #8,046 most-billed Medicaid procedure code, with $7K in payments across 244 claims from 2018–2024. The national median cost per claim is $17.63. Costs vary widely — the 90th percentile is $70.96 per claim, 4.0× the median.

Total Paid

$7K

0.00% of all spending

Total Claims

244

Providers

7

Avg Cost/Claim

$28

National Cost Distribution

How much do providers bill per claim for 0091A? Based on 6 providers billing this code nationally.

Median

$17.63

Average

$30.45

Std Dev

$32.90

Max

$80.14

Percentile Distribution (Cost per Claim)

p10
$2.76
p25
$5.34
Median
$17.63
p75
$52.48
p90
$70.96
p95
$75.55
p99
$79.22

50% of providers bill between $5.34 and $52.48 per claim for this code.

90% bill between $2.76 and $70.96.

Top 1% bill above $79.22.

About This Procedure

HCPCS code 0091A was billed by 7 providers across 244 claims, totaling $7K in Medicaid payments from 2018–2024. This code was used for 230 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$17.63

Providers Billing

6

National Spending

$7K

Avg/Median Ratio

1.73×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for 0091A

#ProviderTotal Paid
1The Arizona Partnership For Immunization

Phoenix, AZ · Local Education Agency (LEA)

$5K
21487925665$865
31497107775$517
41376870253$336
51316075062$160
6State Of Indiana Auditor Of State

Indianapolis, IN · Public Health or Welfare

$37
7Altamed Health Services Corp.

Los Angeles, CA · Clinic/Center Federally Qualified Health Center (FQHC)

$0

Showing top 7 of 7 providers billing this code