0516
HCPCS Procedure Code
HCPCS code 0516 is the #3,619 most-billed Medicaid procedure code, with $1.4M in payments across 57K claims from 2018–2024. The national median cost per claim is $22.37.
Total Paid
$1.4M
0.00% of all spending
Total Claims
57K
Providers
22
Avg Cost/Claim
$25
National Cost Distribution
How much do providers bill per claim for 0516? Based on 20 providers billing this code nationally.
Median
$22.37
Average
$24.44
Std Dev
$14.12
Max
$58.98
Percentile Distribution (Cost per Claim)
50% of providers bill between $15.61 and $28.89 per claim for this code.
90% bill between $11.48 and $41.57.
Top 1% bill above $58.02.
About This Procedure
HCPCS code 0516 was billed by 22 providers across 57K claims, totaling $1.4M in Medicaid payments from 2018–2024. This code was used for 53K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$22.37
Providers Billing
20
National Spending
$1.4M
Avg/Median Ratio
1.09×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for 0516
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1316938301 | $498K |
| 2 | Seventh-day Adventists Loma Linda University Medical Center Loma Linda, CA · General Acute Care Hospital | $446K |
| 3 | 1780877613 | $190K |
| 4 | 1023010113 | $101K |
| 5 | City & County Of San Francisco San Francisco, CA · Case Manager/Care Coordinator | $47K |
| 6 | 1144389941 | $41K |
| 7 | 1639207228 | $38K |
| 8 | 1285845982 | $17K |
| 9 | 1386746337 | $11K |
| 10 | 1699986331 | $8K |
| 11 | 1336279959 | $5K |
| 12 | 1811946734 | $5K |
| 13 | 1508996125 | $4K |
| 14 | 1487865184 | $4K |
| 15 | 1184740383 | $3K |
| 16 | 1346302866 | $2K |
| 17 | 1871615765 | $2K |
| 18 | County Of Santa Clara San Jose, CA · Case Manager/Care Coordinator | $2K |
| 19 | 1306056858 | $186 |
| 20 | 1639143381 | $34 |
Showing top 20 of 22 providers billing this code