78816
HCPCS Procedure Code
HCPCS code 78816 is the #1,637 most-billed Medicaid procedure code, with $17.2M in payments across 21K claims from 2018–2024. The national median cost per claim is $561.50. Costs vary widely — the 90th percentile is $1,432.74 per claim, 2.6× the median.
Total Paid
$17.2M
0.00% of all spending
Total Claims
21K
Providers
84
Avg Cost/Claim
$819
National Cost Distribution
How much do providers bill per claim for 78816? Based on 82 providers billing this code nationally.
Median
$561.50
Average
$613.47
Std Dev
$612.87
Max
$3,358.06
Percentile Distribution (Cost per Claim)
50% of providers bill between $71.92 and $889.46 per claim for this code.
90% bill between $63.30 and $1,432.74.
Top 1% bill above $2,333.81.
About This Procedure
HCPCS code 78816 was billed by 84 providers across 21K claims, totaling $17.2M in Medicaid payments from 2018–2024. This code was used for 18K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$561.50
Providers Billing
82
National Spending
$17.2M
Avg/Median Ratio
1.09×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for 78816
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1275630527 | $2.4M |
| 2 | 1144380999 | $2.2M |
| 3 | Stanford Health Care Stanford, CA · General Acute Care Hospital | $2.0M |
| 4 | 1184680480 | $1.7M |
| 5 | 1477549756 | $1.1M |
| 6 | Memorial Hospital For Cancer And Allied Diseases New York, NY · Pharmacy | $995K |
| 7 | City Of Hope National Medical Center Duarte, CA · General Acute Care Hospital | $926K |
| 8 | 1215052527 | $909K |
| 9 | 1760972756 | $530K |
| 10 | 1053307736 | $463K |
| 11 | University Of Kentucky Lexington, KY · General Acute Care Hospital | $441K |
| 12 | Yale New Haven Hospital New Haven, CT · General Acute Care Hospital | $368K |
| 13 | Regents Of The University Of Michigan Ann Arbor, MI · Clinic/Center, End-Stage Renal Disease (ESRD) Treatment | $299K |
| 14 | Beverly Radiology Medical Group Iii Los Angeles, CA · Radiology, Diagnostic Radiology | $270K |
| 15 | 1376685446 | $259K |
| 16 | Ashland Hospital Corporation Ashland, KY · Clinic/Center, Rural Health | $226K |
| 17 | Children's Hospital Medical Center Cincinnati, OH · Clinic/Center, Primary Care | $216K |
| 18 | 1699874248 | $169K |
| 19 | Dana-farber Cancer Institute, Inc. Boston, MA · General Acute Care Hospital | $167K |
| 20 | 1164493847 | $147K |
Showing top 20 of 84 providers billing this code