0521
HCPCS Procedure Code
HCPCS code 0521 is the #1,091 most-billed Medicaid procedure code, with $41.9M in payments across 5.5M claims from 2018–2024. The national median cost per claim is $7.40. Costs vary widely — the 90th percentile is $34.32 per claim, 4.6× the median.
Total Paid
$41.9M
0.00% of all spending
Total Claims
5.5M
Providers
76
Avg Cost/Claim
$8
National Cost Distribution
How much do providers bill per claim for 0521? Based on 49 providers billing this code nationally.
Median
$7.40
Average
$14.32
Std Dev
$16.41
Max
$72.44
Percentile Distribution (Cost per Claim)
50% of providers bill between $4.78 and $18.67 per claim for this code.
90% bill between $1.77 and $34.32.
Top 1% bill above $66.04.
About This Procedure
HCPCS code 0521 was billed by 76 providers across 5.5M claims, totaling $41.9M in Medicaid payments from 2018–2024. This code was used for 2.2M unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$7.40
Providers Billing
49
National Spending
$41.9M
Avg/Median Ratio
1.94×
Moderately skewed
Top Providers Billing This Code
Ranked by total Medicaid payments for 0521
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1447277355 | $6.3M |
| 2 | 1174859425 | $4.4M |
| 3 | 1841217866 | $3.1M |
| 4 | 1275553257 | $3.1M |
| 5 | 1174911317 | $2.4M |
| 6 | 1740222934 | $2.4M |
| 7 | 1629377452 | $1.7M |
| 8 | 1548648801 | $1.5M |
| 9 | 1326065103 | $1.4M |
| 10 | 1275550295 | $1.3M |
| 11 | 1598064008 | $1.3M |
| 12 | 1124045158 | $1.3M |
| 13 | 1003462102 | $1.3M |
| 14 | 1871010280 | $1.2M |
| 15 | 1225054414 | $877K |
| 16 | 1518064948 | $823K |
| 17 | 1417480294 | $804K |
| 18 | 1851417703 | $794K |
| 19 | 1063438232 | $786K |
| 20 | 1679997852 | $783K |
Showing top 20 of 76 providers billing this code