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#2573 of 11K

01966

HCPCS Procedure Code

HCPCS code 01966 is the #2,573 most-billed Medicaid procedure code, with $4.9M in payments across 56K claims from 2018–2024. The national median cost per claim is $80.99. Costs vary widely — the 90th percentile is $757.21 per claim, 9.3× the median.

Total Paid

$4.9M

0.00% of all spending

Total Claims

56K

Providers

54

Avg Cost/Claim

$88

National Cost Distribution

How much do providers bill per claim for 01966? Based on 53 providers billing this code nationally.

Median

$80.99

Average

$187.16

Std Dev

$300.83

Max

$1,073.84

Percentile Distribution (Cost per Claim)

p10
$34.79
p25
$44.96
Median
$80.99
p75
$116.90
p90
$757.21
p95
$1,018.08
p99
$1,063.22

50% of providers bill between $44.96 and $116.90 per claim for this code.

90% bill between $34.79 and $757.21.

Top 1% bill above $1,063.22.

About This Procedure

HCPCS code 01966 was billed by 54 providers across 56K claims, totaling $4.9M in Medicaid payments from 2018–2024. This code was used for 52K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$80.99

Providers Billing

53

National Spending

$4.9M

Avg/Median Ratio

2.31×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for 01966

#ProviderTotal Paid
11164848453$1.3M
21720210883$589K
31609897834$545K
41851523799$414K
51225229743$342K
61497733760$300K
71306909767$191K
81053351973$160K
91568533750$154K
101760544837$85K
111487749495$79K
121043298318$72K
131902512049$67K
141073804795$67K
151609806488$57K
16Yale University

New Haven, CT · Internal Medicine

$48K
171669607123$44K
181689140626$43K
191235206475$38K
201043304769$36K

Showing top 20 of 54 providers billing this code