0054A
HCPCS Procedure Code
HCPCS code 0054A is the #1,949 most-billed Medicaid procedure code, with $11.1M in payments across 259K claims from 2018–2024. The national median cost per claim is $35.83.
Total Paid
$11.1M
0.00% of all spending
Total Claims
259K
Providers
1K
Avg Cost/Claim
$43
National Cost Distribution
How much do providers bill per claim for 0054A? Based on 1K providers billing this code nationally.
Median
$35.83
Average
$45.04
Std Dev
$78.01
Max
$640.00
Percentile Distribution (Cost per Claim)
50% of providers bill between $26.57 and $40.92 per claim for this code.
90% bill between $14.57 and $54.17.
Top 1% bill above $601.39.
About This Procedure
HCPCS code 0054A was billed by 1K providers across 259K claims, totaling $11.1M in Medicaid payments from 2018–2024. This code was used for 238K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$35.83
Providers Billing
1K
National Spending
$11.1M
Avg/Median Ratio
1.26×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for 0054A
| # | Provider | Total Paid |
|---|---|---|
| 1 | Dhhs Phs Naihs Shiprock Hospital Shiprock, NM · General Acute Care Hospital | $921K |
| 2 | Rosebud Indian Health Service Rosebud, SD · General Acute Care Hospital | $628K |
| 3 | Dhhs,phs,naihs, Gallup Indian Medical Center Gallup, NM · General Acute Care Hospital | $566K |
| 4 | Phs Indian Hospital Red Lake, MN · General Acute Care Hospital | $424K |
| 5 | Permanente Medical Group Inc Stockton, CA · Anesthesiology | $380K |
| 6 | County Of Santa Clara San Jose, CA · Case Manager/Care Coordinator | $359K |
| 7 | Zuni Indian Hospital Zuni, NM · General Acute Care Hospital | $319K |
| 8 | Permanente Medical Group Inc Richmond, CA · Internal Medicine | $219K |
| 9 | Dhhs Phs Naihs Crownpoint Hospital Crownpoint, NM · General Acute Care Hospital | $198K |
| 10 | Medical Associates Of Ebnhc East Boston, MA · Clinic/Center, Community Health | $149K |
| 11 | Kaiser Foundation Health Plan Of The Northwest Portland, OR · General Practice | $124K |
| 12 | State Of Indiana Auditor Of State Indianapolis, IN · Public Health or Welfare | $118K |
| 13 | The Griffin Hospital Derby, CT · Clinic/Center, Emergency Care | $110K |
| 14 | 1417082215 | $93K |
| 15 | Southern California Permanente Medical Group San Diego, CA · Health Maintenance Organization | $89K |
| 16 | Contra Costa County San Pablo, CA · Clinic/Center Federally Qualified Health Center (FQHC) | $84K |
| 17 | Cambridge Public Health Commission Cambridge, MA · General Acute Care Hospital | $83K |
| 18 | Richard Bone Chicago, IL · Internal Medicine, Gastroenterology | $79K |
| 19 | Southern California Permanente Medical Group Bellflower, CA · Health Maintenance Organization | $73K |
| 20 | Contra Costa County Concord, CA · Clinic/Center Federally Qualified Health Center (FQHC) | $72K |
Showing top 20 of 1K providers billing this code