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#627 of 11K

96367

HCPCS Procedure Code

HCPCS code 96367 is the #627 most-billed Medicaid procedure code, with $121.8M in payments across 2.5M claims from 2018–2024. The national median cost per claim is $29.27. Costs vary widely — the 90th percentile is $80.58 per claim, 2.8× the median.

Total Paid

$121.8M

0.01% of all spending

Total Claims

2.5M

Providers

2K

Avg Cost/Claim

$48

National Cost Distribution

How much do providers bill per claim for 96367? Based on 2K providers billing this code nationally.

Median

$29.27

Average

$41.65

Std Dev

$54.43

Max

$1,126.31

Percentile Distribution (Cost per Claim)

p10
$7.00
p25
$16.14
Median
$29.27
p75
$49.31
p90
$80.58
p95
$117.89
p99
$235.77

50% of providers bill between $16.14 and $49.31 per claim for this code.

90% bill between $7.00 and $80.58.

Top 1% bill above $235.77.

About This Procedure

HCPCS code 96367 was billed by 2K providers across 2.5M claims, totaling $121.8M in Medicaid payments from 2018–2024. This code was used for 1.5M unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$29.27

Providers Billing

2K

National Spending

$121.8M

Avg/Median Ratio

1.42×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 96367

#ProviderTotal Paid
11699756221$4.2M
2Adventist Health System-sunbelt, Inc

Orlando, FL · Ambulance, Land Transport

$3.8M
3Rhode Island Hospital

Providence, RI · General Acute Care Hospital

$2.8M
4Hmh Hospitals Corporation

Hackensack, NJ · Ambulance

$2.1M
51366436073$1.7M
6Dana-farber Cancer Institute, Inc.

Boston, MA · General Acute Care Hospital

$1.5M
71679900567$1.3M
8Memorial Hospital For Cancer And Allied Diseases

New York, NY · Pharmacy

$1.1M
9Beth Israel Deaconess Medical Center, Inc.

Boston, MA · General Acute Care Hospital

$1.1M
10The General Hospital Corporation

Boston, MA · General Acute Care Hospital

$1.1M
11Suny Health Science Center At Syracuse

Syracuse, NY · General Acute Care Hospital

$1.1M
121457409674$990K
13Baystate Medical Center Inc

Springfield, MA · General Acute Care Hospital

$953K
14Bakersfield Memorial Hospital

Bakersfield, CA · General Acute Care Hospital

$882K
151609983790$861K
16Umass Memorial Medical Center, Inc.

Worcester, MA · General Acute Care Hospital

$859K
17Froedtert Memorial Lutheran Hospital, Inc.

Milwaukee, WI · Clinic/Center, Radiology

$842K
181184197683$789K
191447276605$767K
201346211323$740K

Showing top 20 of 2K providers billing this code