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#1289 of 11K

0520

HCPCS Procedure Code

HCPCS code 0520 is the #1,289 most-billed Medicaid procedure code, with $29.0M in payments across 124K claims from 2018–2024. The national median cost per claim is $71.00. Costs vary widely — the 90th percentile is $149.62 per claim, 2.1× the median.

Total Paid

$29.0M

0.00% of all spending

Total Claims

124K

Providers

17

Avg Cost/Claim

$234

National Cost Distribution

How much do providers bill per claim for 0520? Based on 14 providers billing this code nationally.

Median

$71.00

Average

$101.72

Std Dev

$132.33

Max

$512.22

Percentile Distribution (Cost per Claim)

p10
$10.89
p25
$17.88
Median
$71.00
p75
$139.78
p90
$149.62
p95
$278.50
p99
$465.48

50% of providers bill between $17.88 and $139.78 per claim for this code.

90% bill between $10.89 and $149.62.

Top 1% bill above $465.48.

About This Procedure

HCPCS code 0520 was billed by 17 providers across 124K claims, totaling $29.0M in Medicaid payments from 2018–2024. This code was used for 77K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$71.00

Providers Billing

14

National Spending

$29.0M

Avg/Median Ratio

1.43×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 0520

#ProviderTotal Paid
11992779417$19.1M
21811914674$4.6M
31811926058$2.7M
41700803285$2.2M
51184641664$95K
61326105909$76K
71134286727$69K
81114084894$61K
91376874966$44K
101215327804$38K
111265599732$24K
121992012306$12K
131679988950$3K
141811279763$249
151245356674$0
161205951738$0
171306062419$0

Showing top 17 of 17 providers billing this code