#5086 of 11K

0598T

HCPCS Procedure Code

HCPCS code 0598T is the #5,086 most-billed Medicaid procedure code, with $297K in payments across 53K claims from 2018–2024. The national median cost per claim is $11.39. Costs vary widely — the 90th percentile is $38.30 per claim, 3.4× the median.

Total Paid

$297K

0.00% of all spending

Total Claims

53K

Providers

Avg Cost/Claim

National Cost Distribution

How much do providers bill per claim for 0598T? Based on 27 providers billing this code nationally.

Median

$11.39

Average

$18.17

Std Dev

$15.71

Max

$54.22

Percentile Distribution (Cost per Claim)

p10

$2.55

p25

$4.86

Median

$11.39

p75

$31.66

p90

$38.30

p95

$42.59

p99

$51.45

50% of providers bill between $4.86 and $31.66 per claim for this code.

90% bill between $2.55 and $38.30.

Top 1% bill above $51.45.

About This Procedure

HCPCS code 0598T was billed by 37 providers across 53K claims, totaling $297K in Medicaid payments from 2018–2024. This code was used for 22K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$11.39

Providers Billing

National Spending

$297K

Avg/Median Ratio

1.60×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for 0598T

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1841657053	$111K	$4.45	0.4× median	Below Median
2	1275869802	$94K	$5.27	0.5× median	Below Median
3	1619973542	$33K	$17.16	1.5× median	Above Median
4	1568793750	$23K	$8.78	0.8× median	Below Median
5	1356484703	$8K	$8.03	0.7× median	Below Median
6	1396394961	$5K	$33.13	2.9× median	Above 75th
7	1598541427	$4K	$11.39	1.0× median	Below Median
8	1093263055	$3K	$31.86	2.8× median	Above 75th
9	1245622562	$3K	$2.11	0.2× median	Below Median
10	1801447784	$2K	$2.85	0.3× median	Below Median
11	1033118104	$2K	$54.22	4.8× median	Top 1%
12	1497750244	$1K	$31.15	2.7× median	Above Median
13	1215593991	$1K	$36.93	3.2× median	Above 75th
14	1932335551	$873	$21.82	1.9× median	Above Median
15	1407962046	$827	$43.55	3.8× median	Top 10%
16	1972269033	$750	$8.62	0.8× median	Below Median
17	1942256490	$726	$40.35	3.5× median	Top 10%
18	1922144757	$693	$28.88	2.5× median	Above Median
19	1497132286	$603	$33.52	2.9× median	Above 75th
20	1073765475	$440	$31.46	2.8× median	Above Median

Showing top 20 of 37 providers billing this code

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