97026
HCPCS Procedure Code
HCPCS code 97026 is the #3,010 most-billed Medicaid procedure code, with $2.8M in payments across 524K claims from 2018–2024. The national median cost per claim is $4.04. Costs vary widely — the 90th percentile is $10.60 per claim, 2.6× the median.
Total Paid
$2.8M
0.00% of all spending
Total Claims
524K
Providers
327
Avg Cost/Claim
$5
National Cost Distribution
How much do providers bill per claim for 97026? Based on 249 providers billing this code nationally.
Median
$4.04
Average
$5.46
Std Dev
$5.23
Max
$34.66
Percentile Distribution (Cost per Claim)
50% of providers bill between $1.70 and $8.34 per claim for this code.
90% bill between $0.29 and $10.60.
Top 1% bill above $22.59.
About This Procedure
HCPCS code 97026 was billed by 327 providers across 524K claims, totaling $2.8M in Medicaid payments from 2018–2024. This code was used for 209K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$4.04
Providers Billing
249
National Spending
$2.8M
Avg/Median Ratio
1.35×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for 97026
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1184684417 | $282K |
| 2 | 1417485889 | $233K |
| 3 | 1114008653 | $199K |
| 4 | 1225139165 | $131K |
| 5 | 1407993405 | $95K |
| 6 | 1194879254 | $91K |
| 7 | 1457514382 | $69K |
| 8 | 1467944884 | $63K |
| 9 | 1578648358 | $62K |
| 10 | 1235401118 | $60K |
| 11 | 1427449024 | $60K |
| 12 | 1568761971 | $59K |
| 13 | 1669505160 | $58K |
| 14 | 1447283353 | $54K |
| 15 | 1932398146 | $52K |
| 16 | 1881103133 | $42K |
| 17 | 1093163289 | $40K |
| 18 | 1922194646 | $39K |
| 19 | 1992850689 | $36K |
| 20 | 1073635231 | $36K |
Showing top 20 of 327 providers billing this code