#3734 of 11K

69200

HCPCS Procedure Code

HCPCS code 69200 is the #3,734 most-billed Medicaid procedure code, with $1.3M in payments across 30K claims from 2018–2024. The national median cost per claim is $51.29. Costs vary widely — the 90th percentile is $121.26 per claim, 2.4× the median.

Total Paid

$1.3M

0.00% of all spending

Total Claims

30K

Providers

117

Avg Cost/Claim

$42

National Cost Distribution

How much do providers bill per claim for 69200? Based on 105 providers billing this code nationally.

Median

$51.29

Average

$59.29

Std Dev

$51.59

Max

$289.45

Percentile Distribution (Cost per Claim)

p10

$9.03

p25

$24.83

Median

$51.29

p75

$74.04

p90

$121.26

p95

$149.02

p99

$256.01

50% of providers bill between $24.83 and $74.04 per claim for this code.

90% bill between $9.03 and $121.26.

Top 1% bill above $256.01.

About This Procedure

HCPCS code 69200 was billed by 117 providers across 30K claims, totaling $1.3M in Medicaid payments from 2018–2024. This code was used for 24K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$51.29

Providers Billing

105

National Spending

$1.3M

Avg/Median Ratio

1.16×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 69200

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1407946288	$198K	$74.04	1.4× median	Above Median
2	1831434497	$158K	$30.44	0.6× median	Below Median
3	1093794604	$121K	$41.22	0.8× median	Below Median
4	1285197020	$103K	$45.84	0.9× median	Below Median
5	1750402038	$60K	$61.39	1.2× median	Above Median
6	1770590945	$59K	$59.72	1.2× median	Above Median
7	Montefiore Medical Center Bronx, NY · General Acute Care Hospital	$49K	$57.55	1.1× median	Above Median
8	City Medical Of Upper East Side Pllc New York, NY · Clinic/Center Urgent Care	$31K	$31.55	0.6× median	Below Median
9	Children's Hospital Washington, DC · General Acute Care Hospital Children	$29K	$86.52	1.7× median	Above 75th
10	Adventist Health System-sunbelt, Inc Orlando, FL · Ambulance, Land Transport	$28K	$69.44	1.4× median	Above Median
11	Vhs Childrens Hospital Of Michigan Inc Detroit, MI · Clinic/Center, Ambulatory Surgical	$27K	$31.57	0.6× median	Below Median
12	1851357560	$25K	$69.04	1.3× median	Above Median
13	Children's Hospital Of Wisconsin, Inc. Milwaukee, WI · Dentist, Pediatric Dentistry	$25K	$20.02	0.4× median	Below Median
14	Umass Memorial Medical Center, Inc. Worcester, MA · General Acute Care Hospital	$23K	$74.18	1.4× median	Above 75th
15	1871569269	$21K	$32.50	0.6× median	Below Median
16	State Of Mississippi - University Of Mississippi Medical Center Jackson, MS · General Acute Care Hospital	$18K	$47.51	0.9× median	Below Median
17	1942318084	$18K	$79.57	1.6× median	Above 75th
18	1649323601	$12K	$77.01	1.5× median	Above 75th
19	1073827101	$12K	$29.92	0.6× median	Below Median
20	1225110406	$11K	$63.57	1.2× median	Above Median

Showing top 20 of 117 providers billing this code

Related Procedures

69210$34.3M 69209$1.3M 69205$71K

← All procedures Top providers →