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

#2024 of 11K

10005

HCPCS Procedure Code

HCPCS code 10005 is the #2,024 most-billed Medicaid procedure code, with $9.9M in payments across 74K claims from 2018–2024. The national median cost per claim is $97.92. Costs vary widely — the 90th percentile is $416.24 per claim, 4.3× the median.

Total Paid

$9.9M

0.00% of all spending

Total Claims

74K

Providers

210

Avg Cost/Claim

$133

National Cost Distribution

How much do providers bill per claim for 10005? Based on 205 providers billing this code nationally.

Median

$97.92

Average

$170.30

Std Dev

$164.37

Max

$924.60

Percentile Distribution (Cost per Claim)

p10
$31.77
p25
$54.91
Median
$97.92
p75
$263.08
p90
$416.24
p95
$497.93
p99
$653.18

50% of providers bill between $54.91 and $263.08 per claim for this code.

90% bill between $31.77 and $416.24.

Top 1% bill above $653.18.

About This Procedure

HCPCS code 10005 was billed by 210 providers across 74K claims, totaling $9.9M in Medicaid payments from 2018–2024. This code was used for 66K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$97.92

Providers Billing

205

National Spending

$9.9M

Avg/Median Ratio

1.74×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for 10005

#ProviderTotal Paid
1Englewood Hospital And Medical Center

Englewood, NJ · General Acute Care Hospital

$747K
21740460583$665K
31104810308$404K
41841496122$312K
5The Cooper Health System

Camden, NJ · General Acute Care Hospital

$301K
6University Of Kentucky

Lexington, KY · General Acute Care Hospital

$286K
7Beth Israel Medical Center

Brooklyn, NY · Psychiatric Unit

$284K
81336461128$282K
91366459570$232K
10The Cleveland Clinic Foundation

Cleveland, OH · General Acute Care Hospital

$230K
11Regents Of The University Of Michigan

Ann Arbor, MI · Clinic/Center, End-Stage Renal Disease (ESRD) Treatment

$227K
121740345669$221K
13Rector & Visitors Of The University Of Virginia

Charlottesville, VA · General Acute Care Hospital

$213K
14Temple University Hospital Inc

Philadelphia, PA · General Acute Care Hospital

$201K
15Umass Memorial Medical Center, Inc.

Worcester, MA · General Acute Care Hospital

$199K
161396747861$197K
171437230034$190K
18Nyu Langone Hospitals

New York, NY · Clinic/Center, Oncology

$186K
19Brigham & Womens Hospital Inc.

Boston, MA · General Acute Care Hospital

$180K
20Boston Medical Center Corporation

Boston, MA · General Acute Care Hospital

$164K

Showing top 20 of 210 providers billing this code