Statistical flags indicate unusual patterns — not proof of fraud or wrongdoing. Read our methodology

#4784 of 11K

Z5916

HCPCS Procedure Code

HCPCS code Z5916 is the #4,784 most-billed Medicaid procedure code, with $403K in payments across 11K claims from 2018–2024. The national median cost per claim is $33.21.

Total Paid

$403K

0.00% of all spending

Total Claims

11K

Providers

9

Avg Cost/Claim

$36

National Cost Distribution

How much do providers bill per claim for Z5916? Based on 9 providers billing this code nationally.

Median

$33.21

Average

$38.22

Std Dev

$8.34

Max

$51.71

Percentile Distribution (Cost per Claim)

p10
$32.37
p25
$32.43
Median
$33.21
p75
$43.52
p90
$51.47
p95
$51.59
p99
$51.69

50% of providers bill between $32.43 and $43.52 per claim for this code.

90% bill between $32.37 and $51.47.

Top 1% bill above $51.69.

About This Procedure

HCPCS code Z5916 was billed by 9 providers across 11K claims, totaling $403K in Medicaid payments from 2018–2024. This code was used for 11K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$33.21

Providers Billing

9

National Spending

$403K

Avg/Median Ratio

1.15×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for Z5916

#ProviderTotal Paid
11902846306$123K
21215993704$79K
31710065933$59K
41467442749$42K
51598854846$28K
61386162949$25K
71962800235$23K
81275583205$21K
9Regents Of The University Of California

Sacramento, CA · General Acute Care Hospital

$3K

Showing top 9 of 9 providers billing this code