Statistical flags indicate unusual patterns — not proof of fraud or wrongdoing. Read our methodology

#2466 of 11K

00920

HCPCS Procedure Code

HCPCS code 00920 is the #2,466 most-billed Medicaid procedure code, with $5.6M in payments across 68K claims from 2018–2024. The national median cost per claim is $88.17. Costs vary widely — the 90th percentile is $194.93 per claim, 2.2× the median.

Total Paid

$5.6M

0.00% of all spending

Total Claims

68K

Providers

204

Avg Cost/Claim

$82

National Cost Distribution

How much do providers bill per claim for 00920? Based on 191 providers billing this code nationally.

Median

$88.17

Average

$104.70

Std Dev

$72.17

Max

$468.42

Percentile Distribution (Cost per Claim)

p10
$34.75
p25
$53.46
Median
$88.17
p75
$143.87
p90
$194.93
p95
$240.59
p99
$302.81

50% of providers bill between $53.46 and $143.87 per claim for this code.

90% bill between $34.75 and $194.93.

Top 1% bill above $302.81.

About This Procedure

HCPCS code 00920 was billed by 204 providers across 68K claims, totaling $5.6M in Medicaid payments from 2018–2024. This code was used for 60K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$88.17

Providers Billing

191

National Spending

$5.6M

Avg/Median Ratio

1.19×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 00920

#ProviderTotal Paid
1The Nemours Foundation

Wilmington, DE · Clinic/Center, Developmental Disabilities

$358K
21699710749$309K
31366412553$304K
41427093863$190K
51720087802$174K
61518912302$160K
71174032254$150K
81346267267$144K
91225016926$143K
10Ahs Hospital Corp.

Morristown, NJ · General Acute Care Hospital

$141K
111093767766$125K
12Children's Hospital Medical Center

Cincinnati, OH · Clinic/Center, Primary Care

$123K
131437203098$114K
14Florida Clinical Practice Association Inc

Gainesville, FL · Surgery

$114K
151336488568$113K
161558314427$111K
171972126209$111K
18Vanderbilt University Medical Center

Nashville, TN · Transplant Surgery

$93K
191053354233$93K
201619452901$92K

Showing top 20 of 204 providers billing this code