97169
HCPCS Procedure Code
HCPCS code 97169 is the #4,060 most-billed Medicaid procedure code, with $883K in payments across 50K claims from 2018–2024. The national median cost per claim is $22.00.
Total Paid
$883K
0.00% of all spending
Total Claims
50K
Providers
225
Avg Cost/Claim
$18
National Cost Distribution
How much do providers bill per claim for 97169? Based on 215 providers billing this code nationally.
Median
$22.00
Average
$21.28
Std Dev
$9.48
Max
$50.00
Percentile Distribution (Cost per Claim)
50% of providers bill between $15.87 and $26.88 per claim for this code.
90% bill between $9.61 and $31.45.
Top 1% bill above $44.44.
About This Procedure
HCPCS code 97169 was billed by 225 providers across 50K claims, totaling $883K in Medicaid payments from 2018–2024. This code was used for 48K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$22.00
Providers Billing
215
National Spending
$883K
Avg/Median Ratio
0.97×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for 97169
| # | Provider | Total Paid |
|---|---|---|
| 1 | Legacy Community Health Services, Inc Houston, TX · Pediatrics | $87K |
| 2 | Topcare Medical Group Inc Dallas, TX · Pediatrics | $72K |
| 3 | 1508047275 | $34K |
| 4 | 1891848297 | $28K |
| 5 | 1730775354 | $23K |
| 6 | 1326045774 | $23K |
| 7 | 1326029331 | $22K |
| 8 | 1245313329 | $22K |
| 9 | 1528021888 | $22K |
| 10 | 1457624082 | $22K |
| 11 | 1790720647 | $20K |
| 12 | 1851457691 | $20K |
| 13 | 1780799171 | $16K |
| 14 | 1053492306 | $15K |
| 15 | 1265568042 | $15K |
| 16 | 1093878506 | $13K |
| 17 | El Centro Del Barrio, Inc. San Antonio, TX · Clinic/Center, Federally Qualified Health Center (FQHC) | $12K |
| 18 | 1598844805 | $12K |
| 19 | 1609066257 | $11K |
| 20 | 1215066121 | $11K |
Showing top 20 of 225 providers billing this code