#2200 of 11K

K0552

HCPCS Procedure Code

HCPCS code K0552 is the #2,200 most-billed Medicaid procedure code, with $7.9M in payments across 243K claims from 2018–2024. The national median cost per claim is $19.78.

Total Paid

$7.9M

0.00% of all spending

Total Claims

243K

Providers

Avg Cost/Claim

$33

National Cost Distribution

How much do providers bill per claim for K0552? Based on 55 providers billing this code nationally.

Median

$19.78

Average

$44.42

Std Dev

$148.18

Max

$1,034.39

Percentile Distribution (Cost per Claim)

p10

$1.56

p25

$4.17

Median

$19.78

p75

$31.05

p90

$38.01

p95

$53.47

p99

$713.76

50% of providers bill between $4.17 and $31.05 per claim for this code.

90% bill between $1.56 and $38.01.

Top 1% bill above $713.76.

About This Procedure

HCPCS code K0552 was billed by 57 providers across 243K claims, totaling $7.9M in Medicaid payments from 2018–2024. This code was used for 209K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$19.78

Providers Billing

National Spending

$7.9M

Avg/Median Ratio

2.25×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for K0552

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	Edwards Health Care Services Inc. Morehead City, NC · Durable Medical Equipment & Medical Supplies	$1.6M	$33.86	1.7× median	Above 75th
2	1477509628	$1.5M	$30.91	1.6× median	Above Median
3	1982792586	$793K	$44.74	2.3× median	Top 10%
4	1013914027	$692K	$1,034.39	52.3× median	Top 1%
5	Minimed Distribution Corp. Northridge, CA · Durable Medical Equipment & Medical Supplies	$647K	$24.38	1.2× median	Above Median
6	Pal-med Llc Columbia, SC · Durable Medical Equipment & Medical Supplies	$517K	$26.64	1.3× median	Above Median
7	1003813064	$491K	$37.92	1.9× median	Above 75th
8	1619295516	$244K	$46.40	2.3× median	Top 10%
9	1467488148	$238K	$69.96	3.5× median	Top 10%
10	1710932173	$236K	$38.07	1.9× median	Top 10%
11	1770512501	$147K	$25.13	1.3× median	Above Median
12	1609024397	$108K	$27.94	1.4× median	Above Median
13	Byram Healthcare Centers, Inc. Portland, OR · Durable Medical Equipment & Medical Supplies	$97K	$33.06	1.7× median	Above 75th
14	Accredo Health Group Inc Warrendale, PA · Pharmacy, Community/Retail Pharmacy	$87K	$11.28	0.6× median	Below Median
15	J&b Medical Supply Co Inc Wixom, MI · Durable Medical Equipment & Medical Supplies	$83K	$20.16	1.0× median	Above Median
16	1124213855	$74K	$27.06	1.4× median	Above Median
17	1710057500	$57K	$440.63	22.3× median	Top 10%
18	Byram Healthcare Centers, Inc. Downers Grove, IL · Durable Medical Equipment & Medical Supplies	$51K	$19.78	1.0× median	Below Median
19	1427139641	$51K	$24.29	1.2× median	Above Median
20	1619956901	$43K	$31.36	1.6× median	Above 75th

Showing top 20 of 57 providers billing this code

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