#1725 of 11K

K0554

HCPCS Procedure Code

HCPCS code K0554 is the #1,725 most-billed Medicaid procedure code, with $15.3M in payments across 168K claims from 2018–2024. The national median cost per claim is $77.38. Costs vary widely — the 90th percentile is $217.03 per claim, 2.8× the median.

Total Paid

$15.3M

0.00% of all spending

Total Claims

168K

Providers

125

Avg Cost/Claim

$91

National Cost Distribution

How much do providers bill per claim for K0554? Based on 122 providers billing this code nationally.

Median

$77.38

Average

$104.41

Std Dev

$96.61

Max

$457.76

Percentile Distribution (Cost per Claim)

p10

$12.98

p25

$31.73

Median

$77.38

p75

$158.91

p90

$217.03

p95

$254.10

p99

$441.03

50% of providers bill between $31.73 and $158.91 per claim for this code.

90% bill between $12.98 and $217.03.

Top 1% bill above $441.03.

About This Procedure

HCPCS code K0554 was billed by 125 providers across 168K claims, totaling $15.3M in Medicaid payments from 2018–2024. This code was used for 146K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$77.38

Providers Billing

122

National Spending

$15.3M

Avg/Median Ratio

1.35×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for K0554

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1245259282	$1.4M	$68.44	0.9× median	Below Median
2	Rgh Enterprises, Llc Twinsburg, OH · Prosthetic/Orthotic Supplier	$1.2M	$138.42	1.8× median	Above Median
3	1376797704	$1.1M	$428.45	5.5× median	Top 10%
4	Benzer Co 1 Llc Byers, CO · Pharmacy Community/Retail Pharmacy	$771K	$205.65	2.7× median	Above 75th
5	1033142948	$749K	$186.99	2.4× median	Above 75th
6	1316903545	$724K	$255.77	3.3× median	Top 10%
7	1093711996	$616K	$136.20	1.8× median	Above Median
8	1700889227	$591K	$33.30	0.4× median	Below Median
9	Degc Enterprises (U.s.), Inc. Clearwater, FL · Durable Medical Equipment & Medical Supplies	$576K	$46.93	0.6× median	Below Median
10	Byram Healthcare Centers, Inc. Torrance, CA · Durable Medical Equipment & Medical Supplies	$574K	$103.90	1.3× median	Above Median
11	Byram Healthcare Centers, Inc. Downers Grove, IL · Durable Medical Equipment & Medical Supplies	$504K	$103.28	1.3× median	Above Median
12	1629013156	$443K	$369.02	4.8× median	Top 10%
13	J&b Medical Supply Co Inc Wixom, MI · Durable Medical Equipment & Medical Supplies	$432K	$219.06	2.8× median	Top 10%
14	1649244138	$403K	$89.69	1.2× median	Above Median
15	1447321674	$321K	$247.73	3.2× median	Top 10%
16	1609024397	$279K	$163.20	2.1× median	Above 75th
17	1235312695	$276K	$53.03	0.7× median	Below Median
18	1114167111	$276K	$79.01	1.0× median	Above Median
19	1356716534	$275K	$87.49	1.1× median	Above Median
20	1295801421	$271K	$142.34	1.8× median	Above Median

Showing top 20 of 125 providers billing this code

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