Statistical flags indicate unusual patterns — not proof of fraud or wrongdoing. Read our methodology

#6206 of 11K

57455

HCPCS Procedure Code

HCPCS code 57455 is the #6,206 most-billed Medicaid procedure code, with $84K in payments across 756 claims from 2018–2024. The national median cost per claim is $115.46. Costs vary widely — the 90th percentile is $269.41 per claim, 2.3× the median.

Total Paid

$84K

0.00% of all spending

Total Claims

756

Providers

14

Avg Cost/Claim

$111

National Cost Distribution

How much do providers bill per claim for 57455? Based on 11 providers billing this code nationally.

Median

$115.46

Average

$175.41

Std Dev

$179.27

Max

$662.95

Percentile Distribution (Cost per Claim)

p10
$53.41
p25
$67.71
Median
$115.46
p75
$218.18
p90
$269.41
p95
$466.18
p99
$623.59

50% of providers bill between $67.71 and $218.18 per claim for this code.

90% bill between $53.41 and $269.41.

Top 1% bill above $623.59.

About This Procedure

HCPCS code 57455 was billed by 14 providers across 756 claims, totaling $84K in Medicaid payments from 2018–2024. This code was used for 594 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$115.46

Providers Billing

11

National Spending

$84K

Avg/Median Ratio

1.52×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for 57455

#ProviderTotal Paid
1Umass Memorial Medical Center, Inc.

Worcester, MA · General Acute Care Hospital

$27K
2The New York And Presbyterian Hospital

New York, NY · General Acute Care Hospital

$17K
3Upmc Magee-womens Hospital

Pittsburgh, PA · General Acute Care Hospital

$9K
4Yale New Haven Hospital

New Haven, CT · General Acute Care Hospital

$7K
51588656268$6K
61235177924$6K
71043304769$4K
81912174921$2K
91346414158$2K
101588820518$1K
111508913088$950
121053651208$0
13Group Health Plan, Inc.

Minneapolis, MN · Clinic/Center, Multi-Specialty

$0
141740437961$0

Showing top 14 of 14 providers billing this code