96411
HCPCS Procedure Code
HCPCS code 96411 is the #1,696 most-billed Medicaid procedure code, with $15.9M in payments across 287K claims from 2018–2024. The national median cost per claim is $33.16. Costs vary widely — the 90th percentile is $138.69 per claim, 4.2× the median.
Total Paid
$15.9M
0.00% of all spending
Total Claims
287K
Providers
320
Avg Cost/Claim
$56
National Cost Distribution
How much do providers bill per claim for 96411? Based on 289 providers billing this code nationally.
Median
$33.16
Average
$54.76
Std Dev
$74.02
Max
$445.67
Percentile Distribution (Cost per Claim)
50% of providers bill between $17.89 and $54.35 per claim for this code.
90% bill between $3.21 and $138.69.
Top 1% bill above $428.38.
About This Procedure
HCPCS code 96411 was billed by 320 providers across 287K claims, totaling $15.9M in Medicaid payments from 2018–2024. This code was used for 177K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$33.16
Providers Billing
289
National Spending
$15.9M
Avg/Median Ratio
1.65×
Moderately skewed
Top Providers Billing This Code
Ranked by total Medicaid payments for 96411
| # | Provider | Total Paid |
|---|---|---|
| 1 | The Cooper Health System Camden, NJ · General Acute Care Hospital | $1.7M |
| 2 | Hmh Hospitals Corporation Hackensack, NJ · Ambulance | $1.5M |
| 3 | Dana-farber Cancer Institute, Inc. Boston, MA · General Acute Care Hospital | $985K |
| 4 | Robert Wood Johnson University Hospital, Inc New Brunswick, NJ · General Acute Care Hospital | $793K |
| 5 | Scottish Rite Children's Medical Center Atlanta, GA · Pediatrics Pediatric Hematology-Oncology | $733K |
| 6 | Yale New Haven Hospital New Haven, CT · General Acute Care Hospital | $567K |
| 7 | Rhode Island Hospital Providence, RI · General Acute Care Hospital | $524K |
| 8 | University Of Kentucky Lexington, KY · General Acute Care Hospital | $452K |
| 9 | Umass Memorial Medical Center, Inc. Worcester, MA · General Acute Care Hospital | $346K |
| 10 | 1871844522 | $321K |
| 11 | University Medical Center, Inc Louisville, KY · Student in an Organized Health Care Education/Training Program | $312K |
| 12 | Memorial Hospital For Cancer And Allied Diseases New York, NY · Pharmacy | $276K |
| 13 | Newark Beth Israel Medical Center Inc Newark, NJ · General Acute Care Hospital | $258K |
| 14 | Englewood Hospital And Medical Center Englewood, NJ · General Acute Care Hospital | $231K |
| 15 | Norton Hospitals Inc Louisville, KY · General Acute Care Hospital | $231K |
| 16 | 1548315401 | $202K |
| 17 | Egleston Children's Hospital At Emory University Inc. Atlanta, GA · Pediatrics Pediatric Emergency Medicine | $196K |
| 18 | Long Island Jewish Medical Center New Hyde Park, NY · General Acute Care Hospital | $189K |
| 19 | The General Hospital Corporation Boston, MA · General Acute Care Hospital | $178K |
| 20 | Montefiore Medical Center Bronx, NY · General Acute Care Hospital | $171K |
Showing top 20 of 320 providers billing this code