#4639 of 11K

00532

HCPCS Procedure Code

HCPCS code 00532 is the #4,639 most-billed Medicaid procedure code, with $475K in payments across 9,286 claims from 2018–2024. The national median cost per claim is $47.70. Costs vary widely — the 90th percentile is $188.82 per claim, 4.0× the median.

Total Paid

$475K

0.00% of all spending

Total Claims

9,286

Providers

Avg Cost/Claim

$51

National Cost Distribution

How much do providers bill per claim for 00532? Based on 34 providers billing this code nationally.

Median

$47.70

Average

$79.76

Std Dev

$82.38

Max

$365.74

Percentile Distribution (Cost per Claim)

p10

$14.02

p25

$38.69

Median

$47.70

p75

$75.90

p90

$188.82

p95

$239.21

p99

$335.43

50% of providers bill between $38.69 and $75.90 per claim for this code.

90% bill between $14.02 and $188.82.

Top 1% bill above $335.43.

About This Procedure

HCPCS code 00532 was billed by 38 providers across 9,286 claims, totaling $475K in Medicaid payments from 2018–2024. This code was used for 8,061 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$47.70

Providers Billing

National Spending

$475K

Avg/Median Ratio

1.67×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for 00532

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1093767766	$109K	$57.70	1.2× median	Above Median
2	1427093863	$90K	$52.19	1.1× median	Above Median
3	1528010428	$62K	$44.90	0.9× median	Below Median
4	1457666828	$60K	$41.06	0.9× median	Below Median
5	1972126209	$28K	$48.43	1.0× median	Above Median
6	1487609475	$20K	$43.35	0.9× median	Below Median
7	The Nemours Foundation Wilmington, DE · Clinic/Center, Developmental Disabilities	$18K	$365.74	7.7× median	Top 1%
8	1497797153	$13K	$42.62	0.9× median	Below Median
9	1669581997	$11K	$43.76	0.9× median	Below Median
10	1417965799	$10K	$198.53	4.2× median	Top 10%
11	1346267267	$9K	$164.74	3.5× median	Above 75th
12	1487602546	$8K	$220.53	4.6× median	Top 10%
13	1750857421	$5K	$11.60	0.2× median	Below Median
14	1417994872	$5K	$77.20	1.6× median	Above 75th
15	1821448150	$4K	$71.99	1.5× median	Above Median
16	1477068971	$3K	$273.90	5.7× median	Top 10%
17	1811997869	$3K	$105.55	2.2× median	Above 75th
18	1407821796	$3K	$55.06	1.2× median	Above Median
19	1871986372	$3K	$50.05	1.0× median	Above Median
20	1558391763	$2K	$166.17	3.5× median	Above 75th

Showing top 20 of 38 providers billing this code

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