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#1856 of 11K

97039

HCPCS Procedure Code

HCPCS code 97039 is the #1,856 most-billed Medicaid procedure code, with $12.6M in payments across 543K claims from 2018–2024. The national median cost per claim is $16.74. Costs vary widely — the 90th percentile is $44.47 per claim, 2.7× the median.

Total Paid

$12.6M

0.00% of all spending

Total Claims

543K

Providers

142

Avg Cost/Claim

$23

National Cost Distribution

How much do providers bill per claim for 97039? Based on 109 providers billing this code nationally.

Median

$16.74

Average

$21.71

Std Dev

$22.12

Max

$152.46

Percentile Distribution (Cost per Claim)

p10
$1.55
p25
$6.81
Median
$16.74
p75
$29.94
p90
$44.47
p95
$58.64
p99
$85.17

50% of providers bill between $6.81 and $29.94 per claim for this code.

90% bill between $1.55 and $44.47.

Top 1% bill above $85.17.

About This Procedure

HCPCS code 97039 was billed by 142 providers across 543K claims, totaling $12.6M in Medicaid payments from 2018–2024. This code was used for 200K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$16.74

Providers Billing

109

National Spending

$12.6M

Avg/Median Ratio

1.30×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 97039

#ProviderTotal Paid
11669420980$2.0M
21407046881$1.5M
31508948837$985K
41215063052$957K
51225139165$636K
61487109674$558K
71194807941$508K
81104120385$501K
91881749323$432K
101144638206$428K
111255376893$408K
121861717605$350K
131487967014$336K
141679599161$234K
151659439834$209K
161760532337$201K
171164453890$175K
181306215850$169K
191114926821$141K
201740348929$134K

Showing top 20 of 142 providers billing this code