92015
Determination of refractive state
Determination of refractive state is the #278 most-billed Medicaid procedure code, with $507.8M in payments across 45.8M claims from 2018–2024. The national median cost per claim is $10.36. Costs vary widely — the 90th percentile is $20.83 per claim, 2.0× the median.
Total Paid
$507.8M
0.05% of all spending
Total Claims
45.8M
Providers
24K
Avg Cost/Claim
$11
National Cost Distribution
How much do providers bill per claim for 92015? Based on 22K providers billing this code nationally.
Median
$10.36
Average
$11.43
Std Dev
$9.54
Max
$339.31
Percentile Distribution (Cost per Claim)
50% of providers bill between $4.91 and $15.99 per claim for this code.
90% bill between $1.54 and $20.83.
Top 1% bill above $38.72.
About This Procedure
HCPCS code 92015 (Determination of refractive state) was billed by 24K providers across 45.8M claims, totaling $507.8M in Medicaid payments from 2018–2024. This code was used for 43.2M unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$10.36
Providers Billing
22K
National Spending
$507.8M
Avg/Median Ratio
1.10×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for 92015
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1417261215 | $3.1M |
| 2 | 1760451470 | $2.2M |
| 3 | 1548256647 | $2.1M |
| 4 | Phoenix Children's Hospital Phoenix, AZ · Pediatrics | $1.8M |
| 5 | Mid Atlantic Pemanente Medical Group Rockville, MD · Health Maintenance Organization | $1.8M |
| 6 | 1831257161 | $1.5M |
| 7 | 1427256593 | $1.4M |
| 8 | 1669448882 | $1.1M |
| 9 | 1679504161 | $1.1M |
| 10 | Permanente Medical Group Inc Stockton, CA · Anesthesiology | $1.0M |
| 11 | 1518331230 | $993K |
| 12 | 1982734653 | $984K |
| 13 | 1447438924 | $958K |
| 14 | 1043275787 | $923K |
| 15 | Park Nicollet Clinic St Louis Park, MN · Obstetrics & Gynecology | $887K |
| 16 | 1609915784 | $860K |
| 17 | 1033161195 | $859K |
| 18 | Group Health Plan, Inc. Minneapolis, MN · Clinic/Center, Multi-Specialty | $853K |
| 19 | Hennepin Healthcare System Inc Minneapolis, MN · General Acute Care Hospital | $846K |
| 20 | 1649563636 | $843K |
Showing top 20 of 24K providers billing this code