96366
IV infusion, therapeutic/prophylactic/diagnostic, each additional hour
IV infusion, therapeutic/prophylactic/diagnostic, each additional hour is the #367 most-billed Medicaid procedure code, with $333.9M in payments across 3.4M claims from 2018–2024. The national median cost per claim is $40.12. Costs vary widely — the 90th percentile is $214.72 per claim, 5.4× the median.
Total Paid
$333.9M
0.03% of all spending
Total Claims
3.4M
Providers
2K
Avg Cost/Claim
$97
National Cost Distribution
How much do providers bill per claim for 96366? Based on 2K providers billing this code nationally.
Median
$40.12
Average
$79.35
Std Dev
$91.42
Max
$916.13
Percentile Distribution (Cost per Claim)
50% of providers bill between $18.12 and $115.19 per claim for this code.
90% bill between $7.65 and $214.72.
Top 1% bill above $371.99.
About This Procedure
HCPCS code 96366 (IV infusion, therapeutic/prophylactic/diagnostic, each additional hour) was billed by 2K providers across 3.4M claims, totaling $333.9M in Medicaid payments from 2018–2024. This code was used for 2.2M unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$40.12
Providers Billing
2K
National Spending
$333.9M
Avg/Median Ratio
1.98×
Moderately skewed
Top Providers Billing This Code
Ranked by total Medicaid payments for 96366
| # | Provider | Total Paid |
|---|---|---|
| 1 | Children's Hospital Corporation Boston, MA · Clinic/Center | $7.7M |
| 2 | Virginia Commonwealth University Health System Authority Richmond, VA · General Acute Care Hospital | $6.2M |
| 3 | The General Hospital Corporation Boston, MA · General Acute Care Hospital | $4.6M |
| 4 | Baystate Medical Center Inc Springfield, MA · General Acute Care Hospital | $3.4M |
| 5 | Boston Medical Center Corporation Boston, MA · General Acute Care Hospital | $3.4M |
| 6 | Umass Memorial Medical Center, Inc. Worcester, MA · General Acute Care Hospital | $3.3M |
| 7 | Beth Israel Deaconess Medical Center, Inc. Boston, MA · General Acute Care Hospital | $3.3M |
| 8 | Rector & Visitors Of The University Of Virginia Charlottesville, VA · General Acute Care Hospital | $3.0M |
| 9 | The Cleveland Clinic Foundation Cleveland, OH · General Acute Care Hospital | $2.8M |
| 10 | Southcoast Hospitals Group, Inc New Bedford, MA · General Acute Care Hospital | $2.8M |
| 11 | Multicare Health System Tacoma, WA · Community/Behavioral Health | $2.7M |
| 12 | 1134178999 | $2.6M |
| 13 | Inova Health Care Services Falls Church, VA · Clinic/Center, Rehabilitation, Substance Use Disorder | $2.6M |
| 14 | Swedish Health Services Seattle, WA · General Acute Care Hospital | $2.5M |
| 15 | Children's Hospital Washington, DC · General Acute Care Hospital Children | $2.3M |
| 16 | Ohiohealth Corporation Columbus, OH · General Acute Care Hospital | $2.2M |
| 17 | University Of Cincinnati Medical Center, Llc Cincinnati, OH · General Acute Care Hospital | $2.2M |
| 18 | University Of Kentucky Lexington, KY · General Acute Care Hospital | $2.2M |
| 19 | The Metrohealth System Cleveland, OH · General Acute Care Hospital | $2.1M |
| 20 | Froedtert Memorial Lutheran Hospital, Inc. Milwaukee, WI · Clinic/Center, Radiology | $2.0M |
Showing top 20 of 2K providers billing this code