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#341 of 11K

67028

Intravitreal injection of a pharmacologic agent

Intravitreal injection of a pharmacologic agent is the #341 most-billed Medicaid procedure code, with $389.1M in payments across 4.3M claims from 2018–2024. The national median cost per claim is $58.82. Costs vary widely — the 90th percentile is $197.74 per claim, 3.4× the median.

Total Paid

$389.1M

0.04% of all spending

Total Claims

4.3M

Providers

2K

Avg Cost/Claim

$90

National Cost Distribution

How much do providers bill per claim for 67028? Based on 2K providers billing this code nationally.

Median

$58.82

Average

$90.40

Std Dev

$89.19

Max

$1,218.13

Percentile Distribution (Cost per Claim)

p10
$23.81
p25
$36.30
Median
$58.82
p75
$119.00
p90
$197.74
p95
$255.89
p99
$394.11

50% of providers bill between $36.30 and $119.00 per claim for this code.

90% bill between $23.81 and $197.74.

Top 1% bill above $394.11.

About This Procedure

HCPCS code 67028 (Intravitreal injection of a pharmacologic agent) was billed by 2K providers across 4.3M claims, totaling $389.1M in Medicaid payments from 2018–2024. This code was used for 3.5M unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$58.82

Providers Billing

2K

National Spending

$389.1M

Avg/Median Ratio

1.54×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for 67028

#ProviderTotal Paid
11760541569$17.4M
21114033404$12.6M
31104221035$8.6M
41134164023$6.8M
51083757322$5.9M
61174557805$5.8M
71962422709$5.5M
81083707822$4.5M
91386737617$3.9M
101114931052$3.9M
111477532174$3.8M
121487798773$3.2M
131639101751$3.1M
141891783965$2.8M
151164578894$2.7M
161073970687$2.6M
171104868520$2.5M
181205847746$2.5M
191497828321$2.4M
201659326452$2.4M

Showing top 20 of 2K providers billing this code

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