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#4289 of 11K

00520

HCPCS Procedure Code

HCPCS code 00520 is the #4,289 most-billed Medicaid procedure code, with $692K in payments across 12K claims from 2018–2024. The national median cost per claim is $71.39. Costs vary widely — the 90th percentile is $155.74 per claim, 2.2× the median.

Total Paid

$692K

0.00% of all spending

Total Claims

12K

Providers

55

Avg Cost/Claim

$60

National Cost Distribution

How much do providers bill per claim for 00520? Based on 50 providers billing this code nationally.

Median

$71.39

Average

$87.34

Std Dev

$59.17

Max

$280.49

Percentile Distribution (Cost per Claim)

p10
$22.58
p25
$48.19
Median
$71.39
p75
$120.18
p90
$155.74
p95
$196.35
p99
$252.46

50% of providers bill between $48.19 and $120.18 per claim for this code.

90% bill between $22.58 and $155.74.

Top 1% bill above $252.46.

About This Procedure

HCPCS code 00520 was billed by 55 providers across 12K claims, totaling $692K in Medicaid payments from 2018–2024. This code was used for 8,697 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$71.39

Providers Billing

50

National Spending

$692K

Avg/Median Ratio

1.22×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 00520

#ProviderTotal Paid
11871986372$102K
2Children's Hospital Medical Center

Cincinnati, OH · Clinic/Center, Primary Care

$94K
31093767766$83K
41225016926$73K
51972126209$71K
61669581997$35K
71487609475$24K
81417994872$21K
91053366377$21K
101558391763$19K
111437292927$15K
121497797153$15K
131346267267$10K
141003989690$9K
15The Cleveland Clinic Foundation

Cleveland, OH · General Acute Care Hospital

$8K
16Banner-university Medical Group

Phoenix, AZ · Clinic/Center, Primary Care

$8K
171528010428$8K
181558314427$8K
191194488791$6K
201629544622$6K

Showing top 20 of 55 providers billing this code