90970
HCPCS Procedure Code
HCPCS code 90970 is the #3,134 most-billed Medicaid procedure code, with $2.4M in payments across 115K claims from 2018–2024. The national median cost per claim is $3.56. Costs vary widely — the 90th percentile is $96.63 per claim, 27.1× the median.
Total Paid
$2.4M
0.00% of all spending
Total Claims
115K
Providers
126
Avg Cost/Claim
$21
National Cost Distribution
How much do providers bill per claim for 90970? Based on 118 providers billing this code nationally.
Median
$3.56
Average
$26.13
Std Dev
$54.23
Max
$238.24
Percentile Distribution (Cost per Claim)
50% of providers bill between $1.45 and $17.41 per claim for this code.
90% bill between $0.76 and $96.63.
Top 1% bill above $229.13.
About This Procedure
HCPCS code 90970 was billed by 126 providers across 115K claims, totaling $2.4M in Medicaid payments from 2018–2024. This code was used for 25K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$3.56
Providers Billing
118
National Spending
$2.4M
Avg/Median Ratio
7.34×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for 90970
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1992796924 | $614K |
| 2 | 1124142971 | $385K |
| 3 | 1144335365 | $228K |
| 4 | 1255632568 | $190K |
| 5 | 1194719203 | $173K |
| 6 | 1144327172 | $156K |
| 7 | 1134404130 | $115K |
| 8 | 1407577216 | $72K |
| 9 | 1164644480 | $67K |
| 10 | 1699043067 | $63K |
| 11 | 1093724346 | $40K |
| 12 | 1932157674 | $34K |
| 13 | 1366539421 | $34K |
| 14 | 1952557860 | $21K |
| 15 | 1750939963 | $21K |
| 16 | 1740765957 | $15K |
| 17 | 1316902208 | $14K |
| 18 | 1760452767 | $14K |
| 19 | 1700855228 | $13K |
| 20 | 1275602765 | $11K |
Showing top 20 of 126 providers billing this code