#2030 of 11K

92504

HCPCS Procedure Code

HCPCS code 92504 is the #2,030 most-billed Medicaid procedure code, with $9.8M in payments across 562K claims from 2018–2024. The national median cost per claim is $16.07. Costs vary widely — the 90th percentile is $33.02 per claim, 2.1× the median.

Total Paid

$9.8M

0.00% of all spending

Total Claims

562K

Providers

813

Avg Cost/Claim

$17

National Cost Distribution

How much do providers bill per claim for 92504? Based on 774 providers billing this code nationally.

Median

$16.07

Average

$19.10

Std Dev

$21.63

Max

$369.42

Percentile Distribution (Cost per Claim)

p10

$3.44

p25

$9.19

Median

$16.07

p75

$23.80

p90

$33.02

p95

$38.65

p99

$91.42

50% of providers bill between $9.19 and $23.80 per claim for this code.

90% bill between $3.44 and $33.02.

Top 1% bill above $91.42.

About This Procedure

HCPCS code 92504 was billed by 813 providers across 562K claims, totaling $9.8M in Medicaid payments from 2018–2024. This code was used for 511K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$16.07

Providers Billing

774

National Spending

$9.8M

Avg/Median Ratio

1.19×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 92504

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1639189236	$487K	$43.87	2.7× median	Top 10%
2	Children's Hospital Of Wisconsin, Inc. Milwaukee, WI · Dentist, Pediatric Dentistry	$320K	$32.71	2.0× median	Above 75th
3	1861592867	$304K	$29.58	1.8× median	Above 75th
4	1508868670	$270K	$26.82	1.7× median	Above 75th
5	1376598326	$231K	$21.11	1.3× median	Above Median
6	1831434497	$211K	$18.91	1.2× median	Above Median
7	Alaska Native Tribal Health Consortium Anchorage, AK · General Acute Care Hospital	$179K	$74.69	4.6× median	Top 10%
8	1811992761	$175K	$27.19	1.7× median	Above 75th
9	1710113949	$166K	$28.39	1.8× median	Above 75th
10	Boston Medical Center Corporation Boston, MA · General Acute Care Hospital	$155K	$24.77	1.5× median	Above 75th
11	1942489042	$145K	$22.01	1.4× median	Above Median
12	1912039710	$138K	$21.47	1.3× median	Above Median
13	1639101751	$132K	$25.48	1.6× median	Above 75th
14	1194772632	$130K	$27.05	1.7× median	Above 75th
15	1609800226	$109K	$12.58	0.8× median	Below Median
16	1639285513	$101K	$11.35	0.7× median	Below Median
17	1508882754	$100K	$16.40	1.0× median	Above Median
18	1831270842	$99K	$261.67	16.3× median	Top 1%
19	1295821825	$98K	$17.37	1.1× median	Above Median
20	Medstar Washington Hospital Center Washington, DC · General Acute Care Hospital	$97K	$38.56	2.4× median	Top 10%

Showing top 20 of 813 providers billing this code

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