Statistical flags indicate unusual patterns — not proof of fraud or wrongdoing. Read our methodology

#2003 of 11K

76937

HCPCS Procedure Code

HCPCS code 76937 is the #2,003 most-billed Medicaid procedure code, with $10.3M in payments across 586K claims from 2018–2024. The national median cost per claim is $6.99. Costs vary widely — the 90th percentile is $35.52 per claim, 5.1× the median.

Total Paid

$10.3M

0.00% of all spending

Total Claims

586K

Providers

1K

Avg Cost/Claim

$18

National Cost Distribution

How much do providers bill per claim for 76937? Based on 1K providers billing this code nationally.

Median

$6.99

Average

$17.04

Std Dev

$40.39

Max

$876.07

Percentile Distribution (Cost per Claim)

p10
$2.03
p25
$4.05
Median
$6.99
p75
$12.70
p90
$35.52
p95
$65.01
p99
$177.22

50% of providers bill between $4.05 and $12.70 per claim for this code.

90% bill between $2.03 and $35.52.

Top 1% bill above $177.22.

About This Procedure

HCPCS code 76937 was billed by 1K providers across 586K claims, totaling $10.3M in Medicaid payments from 2018–2024. This code was used for 485K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$6.99

Providers Billing

1K

National Spending

$10.3M

Avg/Median Ratio

2.44×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for 76937

#ProviderTotal Paid
1Virginia Commonwealth University Health System Authority

Richmond, VA · General Acute Care Hospital

$332K
2Childrens Hospital Of The Kings Daughters Inc

Norfolk, VA · Social Worker, Clinical

$260K
31205835485$255K
41134897424$254K
5Rector & Visitors Of The University Of Virginia

Charlottesville, VA · General Acute Care Hospital

$254K
61548222912$239K
71306952726$232K
8University Of Kentucky

Lexington, KY · General Acute Care Hospital

$225K
91700896354$154K
101033270699$152K
11St Lukes Roosevelt Hospital Center

New York, NY · Case Management

$140K
12The New York And Presbyterian Hospital

New York, NY · General Acute Care Hospital

$138K
13Memorial Hospital For Cancer And Allied Diseases

New York, NY · Pharmacy

$137K
14Seventh-day Adventists Loma Linda University Medical Center

Loma Linda, CA · General Acute Care Hospital

$133K
15Beth Israel Deaconess Medical Center, Inc.

Boston, MA · General Acute Care Hospital

$130K
161346250594$128K
17Multicare Health System

Tacoma, WA · Community/Behavioral Health

$122K
18University Of Washington

Seattle, WA · Clinic/Center, Dental

$121K
191649726738$111K
20Mount Sinai Hospital

New York, NY · Ambulance

$109K

Showing top 20 of 1K providers billing this code