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#1841 of 11K

D5130

HCPCS Procedure Code

HCPCS code D5130 is the #1,841 most-billed Medicaid procedure code, with $13.0M in payments across 23K claims from 2018–2024. The national median cost per claim is $622.74.

Total Paid

$13.0M

0.00% of all spending

Total Claims

23K

Providers

140

Avg Cost/Claim

$558

National Cost Distribution

How much do providers bill per claim for D5130? Based on 131 providers billing this code nationally.

Median

$622.74

Average

$632.51

Std Dev

$201.73

Max

$1,326.54

Percentile Distribution (Cost per Claim)

p10
$400.00
p25
$491.90
Median
$622.74
p75
$822.54
p90
$866.04
p95
$895.21
p99
$1,001.00

50% of providers bill between $491.90 and $822.54 per claim for this code.

90% bill between $400.00 and $866.04.

Top 1% bill above $1,001.00.

About This Procedure

HCPCS code D5130 was billed by 140 providers across 23K claims, totaling $13.0M in Medicaid payments from 2018–2024. This code was used for 21K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$622.74

Providers Billing

131

National Spending

$13.0M

Avg/Median Ratio

1.02×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for D5130

#ProviderTotal Paid
11760891543$750K
21588078273$674K
31619205721$641K
41831371962$618K
51912430778$518K
61851964829$510K
71861152068$460K
81982991311$448K
91831586148$416K
101316340342$407K
111639393846$320K
121689779282$319K
131225013899$294K
141336641109$278K
151629641600$262K
161437435781$260K
171588038327$258K
181225530835$237K
191780713974$221K
201821520842$220K

Showing top 20 of 140 providers billing this code

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