Statistical flags indicate unusual patterns — not proof of fraud or wrongdoing. Read our methodology

#5092 of 11K

0513

HCPCS Procedure Code

HCPCS code 0513 is the #5,092 most-billed Medicaid procedure code, with $294K in payments across 3,822 claims from 2018–2024. The national median cost per claim is $52.79.

Total Paid

$294K

0.00% of all spending

Total Claims

3,822

Providers

2

Avg Cost/Claim

$77

National Cost Distribution

How much do providers bill per claim for 0513? Based on 2 providers billing this code nationally.

Median

$52.79

Average

$52.79

Std Dev

$35.91

Max

$78.18

Percentile Distribution (Cost per Claim)

p10
$32.47
p25
$40.09
Median
$52.79
p75
$65.48
p90
$73.10
p95
$75.64
p99
$77.67

50% of providers bill between $40.09 and $65.48 per claim for this code.

90% bill between $32.47 and $73.10.

Top 1% bill above $77.67.

About This Procedure

HCPCS code 0513 was billed by 2 providers across 3,822 claims, totaling $294K in Medicaid payments from 2018–2024. This code was used for 3,573 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$52.79

Providers Billing

2

National Spending

$294K

Avg/Median Ratio

1.00×

Normal distribution

Provider Coverage

We have 2 providers billing this code in our dataset. Individual provider breakdowns are available for top-spending procedure codes.