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#5005 of 11K

01926

HCPCS Procedure Code

HCPCS code 01926 is the #5,005 most-billed Medicaid procedure code, with $322K in payments across 2K claims from 2018–2024. The national median cost per claim is $153.13. Costs vary widely — the 90th percentile is $391.84 per claim, 2.6× the median.

Total Paid

$322K

0.00% of all spending

Total Claims

2K

Providers

17

Avg Cost/Claim

$144

National Cost Distribution

How much do providers bill per claim for 01926? Based on 16 providers billing this code nationally.

Median

$153.13

Average

$192.76

Std Dev

$148.33

Max

$544.76

Percentile Distribution (Cost per Claim)

p10
$38.20
p25
$118.33
Median
$153.13
p75
$232.49
p90
$391.84
p95
$454.90
p99
$526.79

50% of providers bill between $118.33 and $232.49 per claim for this code.

90% bill between $38.20 and $391.84.

Top 1% bill above $526.79.

About This Procedure

HCPCS code 01926 was billed by 17 providers across 2K claims, totaling $322K in Medicaid payments from 2018–2024. This code was used for 2K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$153.13

Providers Billing

16

National Spending

$322K

Avg/Median Ratio

1.26×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 01926

#ProviderTotal Paid
11093767766$86K
21225016926$60K
31528010428$40K
41376741918$38K
51346706173$31K
61477068971$22K
71710324041$15K
81346267267$9K
91720087802$5K
101346649415$5K
111003989690$4K
121427093863$2K
13Ochsner Clinic Llc

New Orleans, LA · Surgery

$2K
141457666828$2K
151023529591$488
16Nationwide Children's Hospital

Columbus, OH · General Acute Care Hospital

$445
171780667923$0

Showing top 17 of 17 providers billing this code