0551
HCPCS Procedure Code
HCPCS code 0551 is the #786 most-billed Medicaid procedure code, with $80.1M in payments across 1.1M claims from 2018–2024. The national median cost per claim is $2.10. Costs vary widely — the 90th percentile is $157.92 per claim, 75.2× the median.
Total Paid
$80.1M
0.01% of all spending
Total Claims
1.1M
Providers
536
Avg Cost/Claim
$76
National Cost Distribution
How much do providers bill per claim for 0551? Based on 167 providers billing this code nationally.
Median
$2.10
Average
$61.50
Std Dev
$174.67
Max
$2,031.74
Percentile Distribution (Cost per Claim)
50% of providers bill between $0.51 and $76.18 per claim for this code.
90% bill between $0.14 and $157.92.
Top 1% bill above $500.13.
About This Procedure
HCPCS code 0551 was billed by 536 providers across 1.1M claims, totaling $80.1M in Medicaid payments from 2018–2024. This code was used for 200K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$2.10
Providers Billing
167
National Spending
$80.1M
Avg/Median Ratio
29.29×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for 0551
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1194899138 | $39.0M |
| 2 | 1629371398 | $10.5M |
| 3 | 1093801680 | $4.6M |
| 4 | 1215014956 | $2.6M |
| 5 | 1689715674 | $2.5M |
| 6 | 1194812255 | $1.8M |
| 7 | 1225184963 | $1.6M |
| 8 | 1275739047 | $1.5M |
| 9 | 1821043332 | $1.4M |
| 10 | 1841291002 | $1.3M |
| 11 | 1316970064 | $1.1M |
| 12 | 1962474387 | $854K |
| 13 | 1861451841 | $806K |
| 14 | 1013168046 | $727K |
| 15 | 1184804825 | $693K |
| 16 | 1477560035 | $576K |
| 17 | 1649275868 | $569K |
| 18 | 1487657235 | $524K |
| 19 | 1760724231 | $518K |
| 20 | 1154387926 | $510K |
Showing top 20 of 536 providers billing this code