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#306 of 11K

69436

Tympanostomy, general anesthesia

Tympanostomy, general anesthesia is the #306 most-billed Medicaid procedure code, with $460.2M in payments across 1.1M claims from 2018–2024. The national median cost per claim is $205.50. Costs vary widely — the 90th percentile is $1,114.91 per claim, 5.4× the median.

Total Paid

$460.2M

0.04% of all spending

Total Claims

1.1M

Providers

2K

Avg Cost/Claim

$420

National Cost Distribution

How much do providers bill per claim for 69436? Based on 2K providers billing this code nationally.

Median

$205.50

Average

$416.82

Std Dev

$456.98

Max

$3,336.07

Percentile Distribution (Cost per Claim)

p10
$106.97
p25
$138.34
Median
$205.50
p75
$498.02
p90
$1,114.91
p95
$1,435.77
p99
$2,074.89

50% of providers bill between $138.34 and $498.02 per claim for this code.

90% bill between $106.97 and $1,114.91.

Top 1% bill above $2,074.89.

About This Procedure

HCPCS code 69436 (Tympanostomy, general anesthesia) was billed by 2K providers across 1.1M claims, totaling $460.2M in Medicaid payments from 2018–2024. This code was used for 853K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$205.50

Providers Billing

2K

National Spending

$460.2M

Avg/Median Ratio

2.03×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for 69436

#ProviderTotal Paid
1Nationwide Children's Hospital

Columbus, OH · General Acute Care Hospital

$12.3M
2Children's Hospital Medical Center

Cincinnati, OH · Clinic/Center, Primary Care

$11.2M
3Children's Hospital Medical Center Of Akron

Akron, OH · General Acute Care Hospital Children

$10.6M
4State Of Mississippi - University Of Mississippi Medical Center

Jackson, MS · General Acute Care Hospital

$8.6M
5Dayton Children's Hospital

Dayton, OH · General Acute Care Hospital, Children

$8.4M
6Children's Hospital Corporation

Boston, MA · Clinic/Center

$7.0M
7Phoenix Children's Hospital

Phoenix, AZ · General Acute Care Hospital Children

$6.6M
81689632119$6.5M
9Driscoll Childrens Hospital

Corpus Christi, TX · Speech-Language Pathologist,

$6.0M
10Texas Children's Hospital

Houston, TX · General Acute Care Hospital Children

$4.7M
11Vanderbilt University Medical Center

Nashville, TN · Psychiatric Unit

$4.4M
121629161112$4.0M
13Childrens Hospital Of The Kings Daughters Inc

Norfolk, VA · Social Worker, Clinical

$4.0M
14Scottish Rite Children's Medical Center

Atlanta, GA · Pediatrics Pediatric Hematology-Oncology

$3.8M
15Childrens Hospital Of Philadelphia

Philadelphia, PA · General Acute Care Hospital Children

$3.6M
16Connecticut Children's Medical Center

Hartford, CT · General Acute Care Hospital, Children

$3.5M
17University Of Kentucky

Lexington, KY · General Acute Care Hospital

$3.5M
18Children's Health System Of Texas

Dallas, TX · General Acute Care Hospital Children

$3.4M
19Seattle Children's Hospital

Seattle, WA · Prosthetic/Orthotic Supplier

$3.3M
201689664906$3.3M

Showing top 20 of 2K providers billing this code

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