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#5684 of 11K

00537

HCPCS Procedure Code

HCPCS code 00537 is the #5,684 most-billed Medicaid procedure code, with $154K in payments across 697 claims from 2018–2024. The national median cost per claim is $109.89. Costs vary widely — the 90th percentile is $375.33 per claim, 3.4× the median.

Total Paid

$154K

0.00% of all spending

Total Claims

697

Providers

15

Avg Cost/Claim

$222

National Cost Distribution

How much do providers bill per claim for 00537? Based on 15 providers billing this code nationally.

Median

$109.89

Average

$167.08

Std Dev

$158.99

Max

$609.36

Percentile Distribution (Cost per Claim)

p10
$66.43
p25
$84.25
Median
$109.89
p75
$132.62
p90
$375.33
p95
$446.92
p99
$576.87

50% of providers bill between $84.25 and $132.62 per claim for this code.

90% bill between $66.43 and $375.33.

Top 1% bill above $576.87.

About This Procedure

HCPCS code 00537 was billed by 15 providers across 697 claims, totaling $154K in Medicaid payments from 2018–2024. This code was used for 576 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$109.89

Providers Billing

15

National Spending

$154K

Avg/Median Ratio

1.52×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for 00537

#ProviderTotal Paid
11053354233$88K
21417994872$13K
31528010428$11K
41972126209$10K
51093767766$9K
61710324041$6K
7Faculty Physicians And Surgeons Of Llusm

Redlands, CA · Pediatrics

$5K
81407821796$2K
91497797153$2K
101487609475$2K
11Ohio State University Hospitals

Columbus, OH · General Acute Care Hospital

$1K
12The Cleveland Clinic Foundation

Cleveland, OH · General Acute Care Hospital

$1K
131871666479$1K
14Miami Valley Hospital

Dayton, OH · General Acute Care Hospital

$1K
151669581997$1K

Showing top 15 of 15 providers billing this code