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#5020 of 11K

15853

HCPCS Procedure Code

HCPCS code 15853 is the #5,020 most-billed Medicaid procedure code, with $319K in payments across 7,779 claims from 2018–2024. The national median cost per claim is $16.06. Costs vary widely — the 90th percentile is $58.08 per claim, 3.6× the median.

Total Paid

$319K

0.00% of all spending

Total Claims

7,779

Providers

66

Avg Cost/Claim

$41

National Cost Distribution

How much do providers bill per claim for 15853? Based on 45 providers billing this code nationally.

Median

$16.06

Average

$37.16

Std Dev

$69.81

Max

$378.58

Percentile Distribution (Cost per Claim)

p10
$2.88
p25
$6.56
Median
$16.06
p75
$41.62
p90
$58.08
p95
$84.73
p99
$344.32

50% of providers bill between $6.56 and $41.62 per claim for this code.

90% bill between $2.88 and $58.08.

Top 1% bill above $344.32.

About This Procedure

HCPCS code 15853 was billed by 66 providers across 7,779 claims, totaling $319K in Medicaid payments from 2018–2024. This code was used for 7,345 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$16.06

Providers Billing

45

National Spending

$319K

Avg/Median Ratio

2.31×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for 15853

#ProviderTotal Paid
1St. Barnabas Hospital

Bronx, NY · General Acute Care Hospital

$123K
21366496937$86K
3Jersey City Medical Center

Jersey City, NJ · General Acute Care Hospital

$17K
4Montefiore Medical Center

Bronx, NY · General Acute Care Hospital

$14K
5Bronxcare Health System

Bronx, NY · General Acute Care Hospital

$12K
6St Josephs University Medical Center Inc.

Paterson, NJ · General Acute Care Hospital

$11K
7Newark Beth Israel Medical Center Inc

Newark, NJ · General Acute Care Hospital

$6K
8Clara Maass Medical Center

Belleville, NJ · General Acute Care Hospital

$5K
9Hmh Hospitals Corporation

Hackensack, NJ · Ambulance

$5K
101134349954$4K
111598708513$4K
12Richmond Medical Center

Staten Island, NY · Psychiatric Unit

$4K
13Ohiohealth Corporation

Columbus, OH · General Acute Care Hospital

$3K
14Hmh Hospitals Corporation

Edison, NJ · General Acute Care Hospital

$3K
151861439952$3K
161619914785$3K
17Cooperman Barnabas Medical Center Inc

Livingston, NJ · General Acute Care Hospital

$2K
181568688992$2K
19St Elizabeth Medical Center, Inc

Edgewood, KY · Portable X-Ray and/or Other Portable Diagnostic Imaging Supplier

$1K
201083668669$1K

Showing top 20 of 66 providers billing this code