#3191 of 11K

00952

HCPCS Procedure Code

HCPCS code 00952 is the #3,191 most-billed Medicaid procedure code, with $2.3M in payments across 35K claims from 2018–2024. The national median cost per claim is $55.47. Costs vary widely — the 90th percentile is $156.83 per claim, 2.8× the median.

Total Paid

$2.3M

0.00% of all spending

Total Claims

35K

Providers

120

Avg Cost/Claim

$64

National Cost Distribution

How much do providers bill per claim for 00952? Based on 102 providers billing this code nationally.

Median

$55.47

Average

$94.23

Std Dev

$168.85

Max

$1,520.00

Percentile Distribution (Cost per Claim)

p10

$31.93

p25

$39.40

Median

$55.47

p75

$98.18

p90

$156.83

p95

$203.81

p99

$778.83

50% of providers bill between $39.40 and $98.18 per claim for this code.

90% bill between $31.93 and $156.83.

Top 1% bill above $778.83.

About This Procedure

HCPCS code 00952 was billed by 120 providers across 35K claims, totaling $2.3M in Medicaid payments from 2018–2024. This code was used for 27K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$55.47

Providers Billing

102

National Spending

$2.3M

Avg/Median Ratio

1.70×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for 00952

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1871986372	$240K	$53.32	1.0× median	Below Median
2	1053354233	$237K	$313.72	5.7× median	Top 10%
3	1972126209	$194K	$42.41	0.8× median	Below Median
4	1891235404	$179K	$783.23	14.1× median	Top 1%
5	1669581997	$128K	$39.63	0.7× median	Below Median
6	1417994872	$116K	$68.28	1.2× median	Above Median
7	1558314427	$106K	$94.14	1.7× median	Above Median
8	1508138256	$88K	$170.34	3.1× median	Top 10%
9	1225016926	$88K	$46.05	0.8× median	Below Median
10	1053366377	$82K	$63.83	1.2× median	Above Median
11	1497797153	$72K	$43.28	0.8× median	Below Median
12	1205074739	$69K	$87.52	1.6× median	Above Median
13	1487609475	$65K	$41.03	0.7× median	Below Median
14	1740430727	$59K	$94.93	1.7× median	Above Median
15	1922031442	$38K	$58.64	1.1× median	Above Median
16	Ashland Hospital Corporation Ashland, KY · Clinic/Center, Rural Health	$36K	$114.99	2.1× median	Above 75th
17	1003053794	$35K	$77.43	1.4× median	Above Median
18	1407821796	$31K	$42.59	0.8× median	Below Median
19	1295776052	$30K	$37.30	0.7× median	Below Median
20	1154407013	$26K	$158.59	2.9× median	Top 10%

Showing top 20 of 120 providers billing this code

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