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#332 of 11K

90960

End-stage renal disease services, per month, age 20+

End-stage renal disease services, per month, age 20+ is the #332 most-billed Medicaid procedure code, with $403.7M in payments across 5.8M claims from 2018–2024. The national median cost per claim is $52.76. Costs vary widely — the 90th percentile is $147.40 per claim, 2.8× the median.

Total Paid

$403.7M

0.04% of all spending

Total Claims

5.8M

Providers

3K

Avg Cost/Claim

$70

National Cost Distribution

How much do providers bill per claim for 90960? Based on 3K providers billing this code nationally.

Median

$52.76

Average

$70.59

Std Dev

$65.50

Max

$889.38

Percentile Distribution (Cost per Claim)

p10
$15.62
p25
$29.89
Median
$52.76
p75
$88.97
p90
$147.40
p95
$186.44
p99
$331.39

50% of providers bill between $29.89 and $88.97 per claim for this code.

90% bill between $15.62 and $147.40.

Top 1% bill above $331.39.

About This Procedure

HCPCS code 90960 (End-stage renal disease services, per month, age 20+) was billed by 3K providers across 5.8M claims, totaling $403.7M in Medicaid payments from 2018–2024. This code was used for 5.3M unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$52.76

Providers Billing

3K

National Spending

$403.7M

Avg/Median Ratio

1.34×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 90960

#ProviderTotal Paid
11316997505$12.7M
21316902208$11.5M
31447200126$10.0M
41659316008$4.7M
51871699074$4.2M
61962454140$4.2M
71366550675$4.1M
81275604183$3.3M
91205906229$3.3M
101427120682$3.1M
111760497457$2.9M
121144372905$2.9M
131659304467$2.9M
141750835336$2.9M
151942239694$2.8M
161407897358$2.8M
171982763405$2.7M
181982631222$2.4M
191912958422$2.3M
201083664189$2.3M

Showing top 20 of 3K providers billing this code