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#392 of 11K

K0553

Supply allowance for therapeutic CGM, per month

Supply allowance for therapeutic CGM, per month is the #392 most-billed Medicaid procedure code, with $276.6M in payments across 2.5M claims from 2018–2024. The national median cost per claim is $53.20. Costs vary widely — the 90th percentile is $198.32 per claim, 3.7× the median.

Total Paid

$276.6M

0.03% of all spending

Total Claims

2.5M

Providers

357

Avg Cost/Claim

$112

National Cost Distribution

How much do providers bill per claim for K0553? Based on 344 providers billing this code nationally.

Median

$53.20

Average

$93.40

Std Dev

$104.39

Max

$755.67

Percentile Distribution (Cost per Claim)

p10
$11.70
p25
$30.35
Median
$53.20
p75
$124.00
p90
$198.32
p95
$284.93
p99
$487.12

50% of providers bill between $30.35 and $124.00 per claim for this code.

90% bill between $11.70 and $198.32.

Top 1% bill above $487.12.

About This Procedure

HCPCS code K0553 (Supply allowance for therapeutic CGM, per month) was billed by 357 providers across 2.5M claims, totaling $276.6M in Medicaid payments from 2018–2024. This code was used for 2.2M unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$53.20

Providers Billing

344

National Spending

$276.6M

Avg/Median Ratio

1.76×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for K0553

#ProviderTotal Paid
11376797704$23.7M
2Rgh Enterprises, Llc

Twinsburg, OH · Prosthetic/Orthotic Supplier

$19.1M
31033142948$16.0M
41316903545$15.5M
5Byram Healthcare Centers, Inc.

Torrance, CA · Durable Medical Equipment & Medical Supplies

$12.6M
6Benzer Co 1 Llc

Byers, CO · Pharmacy Community/Retail Pharmacy

$12.2M
7J&b Medical Supply Co Inc

Wixom, MI · Durable Medical Equipment & Medical Supplies

$11.7M
81093711996$11.5M
91245259282$10.9M
10Degc Enterprises (U.s.), Inc.

Clearwater, FL · Durable Medical Equipment & Medical Supplies

$10.3M
11Byram Healthcare Centers, Inc.

Downers Grove, IL · Durable Medical Equipment & Medical Supplies

$9.0M
121447321674$9.0M
131700889227$7.2M
141710932173$6.0M
151609024397$5.8M
161235312695$5.6M
171629013156$5.5M
18Edwards Health Care Services, Inc.

Hudson, OH · Durable Medical Equipment & Medical Supplies

$5.3M
191114167111$4.3M
20Byram Healthcare Centers, Inc.

Portland, OR · Durable Medical Equipment & Medical Supplies

$4.0M

Showing top 20 of 357 providers billing this code

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