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#3069 of 11K

0052A

HCPCS Procedure Code

HCPCS code 0052A is the #3,069 most-billed Medicaid procedure code, with $2.6M in payments across 57K claims from 2018–2024. The national median cost per claim is $37.79.

Total Paid

$2.6M

0.00% of all spending

Total Claims

57K

Providers

541

Avg Cost/Claim

$45

National Cost Distribution

How much do providers bill per claim for 0052A? Based on 518 providers billing this code nationally.

Median

$37.79

Average

$50.77

Std Dev

$86.52

Max

$640.00

Percentile Distribution (Cost per Claim)

p10
$21.00
p25
$31.98
Median
$37.79
p75
$41.55
p90
$57.42
p95
$67.00
p99
$610.47

50% of providers bill between $31.98 and $41.55 per claim for this code.

90% bill between $21.00 and $57.42.

Top 1% bill above $610.47.

About This Procedure

HCPCS code 0052A was billed by 541 providers across 57K claims, totaling $2.6M in Medicaid payments from 2018–2024. This code was used for 51K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$37.79

Providers Billing

518

National Spending

$2.6M

Avg/Median Ratio

1.34×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 0052A

#ProviderTotal Paid
1Phs Indian Hospital

Red Lake, MN · General Acute Care Hospital

$134K
2Dhhs Phs Naihs Shiprock Hospital

Shiprock, NM · General Acute Care Hospital

$127K
3County Of Santa Clara

San Jose, CA · Case Manager/Care Coordinator

$95K
4Dhhs,phs,naihs, Gallup Indian Medical Center

Gallup, NM · General Acute Care Hospital

$84K
5Permanente Medical Group Inc

Stockton, CA · Anesthesiology

$82K
61710037288$76K
7The Arizona Partnership For Immunization

Phoenix, AZ · Local Education Agency (LEA)

$74K
8Rosebud Indian Health Service

Rosebud, SD · General Acute Care Hospital

$66K
9Arkansas Childrens Hospital

Little Rock, AR · Clinic/Center, Critical Access Hospital

$52K
10City Of Columbus

Columbus, OH · Clinic/Center, Public Health, State or Local

$49K
11Richard Bone

Chicago, IL · Internal Medicine, Gastroenterology

$47K
12State Of Indiana Auditor Of State

Indianapolis, IN · Public Health or Welfare

$36K
13Permanente Medical Group Inc

Richmond, CA · Internal Medicine

$35K
14Medical Associates Of Ebnhc

East Boston, MA · Clinic/Center, Community Health

$29K
15Aurora Medical Group, Inc.

Milwaukee, WI · Internal Medicine

$29K
16Great Plains Tribal Chairmen's Health Board

Rapid City, SD · Clinic/Center, Urgent Care

$28K
17Rochester General Hospital

Rochester, NY · Dentist, General Practice

$26K
18Pine Ridge Indian Health Service Hospital

Pine Ridge, SD · General Acute Care Hospital

$26K
19Dhhs Phs Naihs Crownpoint Hospital

Crownpoint, NM · General Acute Care Hospital

$26K
20Children's Hospital Corporation

Boston, MA · Clinic/Center

$25K

Showing top 20 of 541 providers billing this code