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#6463 of 11K

91305

HCPCS Procedure Code

HCPCS code 91305 is the #6,463 most-billed Medicaid procedure code, with $63K in payments across 197K claims from 2018–2024. The national median cost per claim is $0.01. Costs vary widely — the 90th percentile is $2.35 per claim, 235.0× the median.

Total Paid

$63K

0.00% of all spending

Total Claims

197K

Providers

1K

Avg Cost/Claim

$0

National Cost Distribution

How much do providers bill per claim for 91305? Based on 207 providers billing this code nationally.

Median

$0.01

Average

$4.07

Std Dev

$31.92

Max

$401.67

Percentile Distribution (Cost per Claim)

p10
$0.00
p25
$0.00
Median
$0.01
p75
$0.14
p90
$2.35
p95
$9.52
p99
$25.43

50% of providers bill between $0.00 and $0.14 per claim for this code.

90% bill between $0.00 and $2.35.

Top 1% bill above $25.43.

About This Procedure

HCPCS code 91305 was billed by 1K providers across 197K claims, totaling $63K in Medicaid payments from 2018–2024. This code was used for 165K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$0.01

Providers Billing

207

National Spending

$63K

Avg/Median Ratio

407.00×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for 91305

#ProviderTotal Paid
1Southcoast Hospitals Group, Inc

New Bedford, MA · General Acute Care Hospital

$12K
2Cornell Scott Hill Health Corporation

New Haven, CT · Psychiatry & Neurology, Child & Adolescent Psychiatry

$9K
31376104125$8K
41548267420$7K
51275196222$6K
61427106871$6K
71164613857$3K
81801835970$2K
91356307581$2K
101942687751$1K
111851300149$897
12Baystate Medical Center Inc

Springfield, MA · General Acute Care Hospital

$741
131972664613$695
141427135268$540
151134474059$381
161598215659$352
17Ochsner Clinic Foundation

New Orleans, LA · General Acute Care Hospital

$334
181962565788$242
19Novant Health Medical Group, Llc

Charlotte, NC · Family Medicine

$191
20Beth Israel Deaconess Medical Center, Inc.

Boston, MA · General Acute Care Hospital

$185

Showing top 20 of 1K providers billing this code