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#4567 of 11K

96369

HCPCS Procedure Code

HCPCS code 96369 is the #4,567 most-billed Medicaid procedure code, with $510K in payments across 5K claims from 2018–2024. The national median cost per claim is $70.59. Costs vary widely — the 90th percentile is $226.21 per claim, 3.2× the median.

Total Paid

$510K

0.00% of all spending

Total Claims

5K

Providers

8

Avg Cost/Claim

$97

National Cost Distribution

How much do providers bill per claim for 96369? Based on 7 providers billing this code nationally.

Median

$70.59

Average

$114.61

Std Dev

$121.37

Max

$379.40

Percentile Distribution (Cost per Claim)

p10
$41.95
p25
$60.40
Median
$70.59
p75
$108.07
p90
$226.21
p95
$302.80
p99
$364.08

50% of providers bill between $60.40 and $108.07 per claim for this code.

90% bill between $41.95 and $226.21.

Top 1% bill above $364.08.

About This Procedure

HCPCS code 96369 was billed by 8 providers across 5K claims, totaling $510K in Medicaid payments from 2018–2024. This code was used for 3K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$70.59

Providers Billing

7

National Spending

$510K

Avg/Median Ratio

1.62×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for 96369

#ProviderTotal Paid
1Optum Women's And Children's Health, Llc

Marietta, GA · Home Health

$182K
21700512365$181K
31841873288$73K
41316925506$41K
51023363348$15K
61871633099$13K
71407405855$5K
81265540256$0

Showing top 8 of 8 providers billing this code