#1039 of 11K

K0005

HCPCS Procedure Code

HCPCS code K0005 is the #1,039 most-billed Medicaid procedure code, with $46.6M in payments across 39K claims from 2018–2024. The national median cost per claim is $1,060.57.

Total Paid

$46.6M

0.00% of all spending

Total Claims

39K

Providers

133

Avg Cost/Claim

$1K

National Cost Distribution

How much do providers bill per claim for K0005? Based on 132 providers billing this code nationally.

Median

$1,060.57

Average

$1,030.44

Std Dev

$521.95

Max

$2,391.17

Percentile Distribution (Cost per Claim)

p10

$221.50

p25

$716.05

Median

$1,060.57

p75

$1,417.75

p90

$1,647.62

p95

$1,742.83

p99

$2,278.16

50% of providers bill between $716.05 and $1,417.75 per claim for this code.

90% bill between $221.50 and $1,647.62.

Top 1% bill above $2,278.16.

About This Procedure

HCPCS code K0005 was billed by 133 providers across 39K claims, totaling $46.6M in Medicaid payments from 2018–2024. This code was used for 34K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$1,060.57

Providers Billing

132

National Spending

$46.6M

Avg/Median Ratio

0.97×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for K0005

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1346711884	$4.8M	$2,391.17	2.3× median	Top 1%
2	1487624193	$3.3M	$1,414.21	1.3× median	Above Median
3	1891750691	$2.7M	$1,625.61	1.5× median	Above 75th
4	1184883472	$2.5M	$1,558.79	1.5× median	Above 75th
5	1932484979	$2.2M	$1,297.89	1.2× median	Above Median
6	1114966181	$2.0M	$1,443.95	1.4× median	Above 75th
7	1003889684	$1.9M	$1,425.69	1.3× median	Above 75th
8	1407497977	$1.7M	$1,353.34	1.3× median	Above Median
9	1639296817	$1.6M	$1,228.00	1.2× median	Above Median
10	1841263621	$1.4M	$865.62	0.8× median	Below Median
11	1982949459	$1.3M	$1,566.70	1.5× median	Above 75th
12	1538576509	$1.2M	$859.73	0.8× median	Below Median
13	1003052598	$1.0M	$1,570.66	1.5× median	Above 75th
14	1871710715	$993K	$1,064.13	1.0× median	Above Median
15	1326011263	$917K	$965.62	0.9× median	Below Median
16	1518231547	$878K	$981.74	0.9× median	Below Median
17	1346588225	$873K	$1,291.50	1.2× median	Above Median
18	1912978669	$687K	$1,108.06	1.0× median	Above Median
19	1144458209	$673K	$1,134.42	1.1× median	Above Median
20	Chesapeake Rehab Equipment Inc Ashland, VA · Durable Medical Equipment & Medical Supplies Customized Equipment	$606K	$1,052.66	1.0× median	Below Median

Showing top 20 of 133 providers billing this code

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