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#1462 of 11K

C1769

HCPCS Procedure Code

HCPCS code C1769 is the #1,462 most-billed Medicaid procedure code, with $22.5M in payments across 1.3M claims from 2018–2024. The national median cost per claim is $7.55. Costs vary widely — the 90th percentile is $66.22 per claim, 8.8× the median.

Total Paid

$22.5M

0.00% of all spending

Total Claims

1.3M

Providers

1K

Avg Cost/Claim

$18

National Cost Distribution

How much do providers bill per claim for C1769? Based on 774 providers billing this code nationally.

Median

$7.55

Average

$25.39

Std Dev

$48.97

Max

$623.69

Percentile Distribution (Cost per Claim)

p10
$0.10
p25
$1.00
Median
$7.55
p75
$28.30
p90
$66.22
p95
$110.83
p99
$221.39

50% of providers bill between $1.00 and $28.30 per claim for this code.

90% bill between $0.10 and $66.22.

Top 1% bill above $221.39.

About This Procedure

HCPCS code C1769 was billed by 1K providers across 1.3M claims, totaling $22.5M in Medicaid payments from 2018–2024. This code was used for 1.1M unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$7.55

Providers Billing

774

National Spending

$22.5M

Avg/Median Ratio

3.36×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for C1769

#ProviderTotal Paid
1Nyu Langone Hospitals

New York, NY · Clinic/Center, Oncology

$1.3M
2University Of Kentucky

Lexington, KY · General Acute Care Hospital

$860K
3Norton Hospitals Inc

Louisville, KY · General Acute Care Hospital

$684K
4Norton Hospitals, Inc

Louisville, KY · General Acute Care Hospital

$634K
5Owensboro Health Inc

Owensboro, KY · General Acute Care Hospital

$485K
61477616571$434K
71538244918$432K
8Rhode Island Hospital

Providence, RI · General Acute Care Hospital

$414K
91366459570$404K
10Montefiore Medical Center

Bronx, NY · General Acute Care Hospital

$385K
11Long Island Jewish Medical Center

New Hyde Park, NY · General Acute Care Hospital

$379K
12Providence Health & Services Washington

Anchorage, AK · General Acute Care Hospital

$373K
131043293608$367K
14Banner - University Medical Center Tucson Campus Llc

Tucson, AZ · Clinic/Center, Multi-Specialty

$364K
151437150984$360K
16Nyu Langone Hospitals

Brooklyn, NY · General Acute Care Hospital

$338K
17St. Mary's Medical Center Inc

Huntington, WV · General Acute Care Hospital

$337K
18West Virginia University Hospitals, Inc

Morgantown, WV · Clinical Medical Laboratory

$288K
19Unm Hospital

Albuquerque, NM · General Acute Care Hospital

$274K
201407877137$258K

Showing top 20 of 1K providers billing this code