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#1821 of 11K

96118

HCPCS Procedure Code

HCPCS code 96118 is the #1,821 most-billed Medicaid procedure code, with $13.3M in payments across 43K claims from 2018–2024. The national median cost per claim is $196.66. Costs vary widely — the 90th percentile is $669.72 per claim, 3.4× the median.

Total Paid

$13.3M

0.00% of all spending

Total Claims

43K

Providers

243

Avg Cost/Claim

$308

National Cost Distribution

How much do providers bill per claim for 96118? Based on 235 providers billing this code nationally.

Median

$196.66

Average

$278.17

Std Dev

$258.32

Max

$1,436.40

Percentile Distribution (Cost per Claim)

p10
$41.38
p25
$96.75
Median
$196.66
p75
$373.44
p90
$669.72
p95
$830.08
p99
$1,082.24

50% of providers bill between $96.75 and $373.44 per claim for this code.

90% bill between $41.38 and $669.72.

Top 1% bill above $1,082.24.

About This Procedure

HCPCS code 96118 was billed by 243 providers across 43K claims, totaling $13.3M in Medicaid payments from 2018–2024. This code was used for 32K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$196.66

Providers Billing

235

National Spending

$13.3M

Avg/Median Ratio

1.41×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 96118

#ProviderTotal Paid
11982074969$1.7M
21437320892$603K
31336245828$577K
41801874573$402K
51821324815$395K
61326152711$384K
71619136983$308K
81639177926$303K
91477534089$292K
101841397114$278K
111417972647$244K
121710102769$238K
131427108323$223K
141689031528$221K
151659689222$219K
161861668139$218K
171235449661$202K
181780658401$195K
191730137753$186K
201932117140$163K

Showing top 20 of 243 providers billing this code