01961
HCPCS Procedure Code
HCPCS code 01961 is the #1,098 most-billed Medicaid procedure code, with $41.1M in payments across 266K claims from 2018–2024. The national median cost per claim is $156.02. Costs vary widely — the 90th percentile is $315.32 per claim, 2.0× the median.
Total Paid
$41.1M
0.00% of all spending
Total Claims
266K
Providers
531
Avg Cost/Claim
$155
National Cost Distribution
How much do providers bill per claim for 01961? Based on 519 providers billing this code nationally.
Median
$156.02
Average
$176.69
Std Dev
$108.82
Max
$738.58
Percentile Distribution (Cost per Claim)
50% of providers bill between $99.57 and $235.01 per claim for this code.
90% bill between $62.43 and $315.32.
Top 1% bill above $516.80.
About This Procedure
HCPCS code 01961 was billed by 531 providers across 266K claims, totaling $41.1M in Medicaid payments from 2018–2024. This code was used for 226K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$156.02
Providers Billing
519
National Spending
$41.1M
Avg/Median Ratio
1.13×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for 01961
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1942270566 | $1.8M |
| 2 | 1053354233 | $1.7M |
| 3 | 1558314427 | $1.4M |
| 4 | 1952311441 | $1.3M |
| 5 | 1871986372 | $810K |
| 6 | 1548208564 | $791K |
| 7 | 1740232768 | $765K |
| 8 | 1972126209 | $694K |
| 9 | 1053366377 | $649K |
| 10 | 1346267267 | $631K |
| 11 | 1225016926 | $603K |
| 12 | 1417994872 | $601K |
| 13 | Ut Physicians Houston, TX · Emergency Medicine | $588K |
| 14 | 1285660704 | $587K |
| 15 | 1902957103 | $587K |
| 16 | 1669409561 | $583K |
| 17 | 1699710749 | $550K |
| 18 | 1669581997 | $507K |
| 19 | 1508138256 | $500K |
| 20 | 1780779082 | $473K |
Showing top 20 of 531 providers billing this code