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#5434 of 11K

0513F

HCPCS Procedure Code

HCPCS code 0513F is the #5,434 most-billed Medicaid procedure code, with $199K in payments across 105K claims from 2018–2024. The national median cost per claim is $2.71. Costs vary widely — the 90th percentile is $13.44 per claim, 5.0× the median.

Total Paid

$199K

0.00% of all spending

Total Claims

105K

Providers

222

Avg Cost/Claim

$2

National Cost Distribution

How much do providers bill per claim for 0513F? Based on 100 providers billing this code nationally.

Median

$2.71

Average

$4.28

Std Dev

$4.83

Max

$17.00

Percentile Distribution (Cost per Claim)

p10
$0.05
p25
$0.37
Median
$2.71
p75
$7.10
p90
$13.44
p95
$15.31
p99
$16.43

50% of providers bill between $0.37 and $7.10 per claim for this code.

90% bill between $0.05 and $13.44.

Top 1% bill above $16.43.

About This Procedure

HCPCS code 0513F was billed by 222 providers across 105K claims, totaling $199K in Medicaid payments from 2018–2024. This code was used for 87K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$2.71

Providers Billing

100

National Spending

$199K

Avg/Median Ratio

1.58×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for 0513F

#ProviderTotal Paid
11669708756$34K
21629219514$29K
31356553549$17K
41396826046$12K
51447464185$12K
61790936854$9K
71790818433$9K
81295711372$8K
91295765378$7K
101437422169$5K
111932498318$5K
121720281421$4K
131912065863$4K
141730398538$4K
151184635153$3K
161497367015$3K
171114433778$2K
181992749873$2K
191205896719$2K
201366651598$2K

Showing top 20 of 222 providers billing this code