#2993 of 11K

20526

HCPCS Procedure Code

HCPCS code 20526 is the #2,993 most-billed Medicaid procedure code, with $2.8M in payments across 50K claims from 2018–2024. The national median cost per claim is $48.63. Costs vary widely — the 90th percentile is $170.13 per claim, 3.5× the median.

Total Paid

$2.8M

0.00% of all spending

Total Claims

50K

Providers

130

Avg Cost/Claim

$56

National Cost Distribution

How much do providers bill per claim for 20526? Based on 130 providers billing this code nationally.

Median

$48.63

Average

$68.32

Std Dev

$63.21

Max

$454.68

Percentile Distribution (Cost per Claim)

p10

$27.50

p25

$35.21

Median

$48.63

p75

$71.15

p90

$170.13

p95

$189.02

p99

$279.95

50% of providers bill between $35.21 and $71.15 per claim for this code.

90% bill between $27.50 and $170.13.

Top 1% bill above $279.95.

About This Procedure

HCPCS code 20526 was billed by 130 providers across 50K claims, totaling $2.8M in Medicaid payments from 2018–2024. This code was used for 44K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$48.63

Providers Billing

130

National Spending

$2.8M

Avg/Median Ratio

1.40×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 20526

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1952402612	$862K	$56.34	1.2× median	Above Median
2	1235123118	$178K	$46.58	1.0× median	Below Median
3	The Cleveland Clinic Foundation Cleveland, OH · General Acute Care Hospital	$156K	$245.71	5.1× median	Top 10%
4	1184828451	$152K	$37.31	0.8× median	Below Median
5	The Metrohealth System Cleveland, OH · General Acute Care Hospital	$146K	$200.54	4.1× median	Top 10%
6	1255791422	$109K	$18.02	0.4× median	Below Median
7	Rector & Visitors Of The University Of Virginia Charlottesville, VA · General Acute Care Hospital	$87K	$293.93	6.0× median	Top 1%
8	Boston Medical Center Corporation Boston, MA · General Acute Care Hospital	$85K	$111.32	2.3× median	Above 75th
9	1407898299	$64K	$85.97	1.8× median	Above 75th
10	1285630129	$62K	$33.33	0.7× median	Below Median
11	1841299039	$57K	$189.31	3.9× median	Top 10%
12	1619010287	$52K	$70.34	1.4× median	Above Median
13	North Shore-lij Medical Pc Great Neck, NY · Urology	$48K	$103.97	2.1× median	Above 75th
14	1144227539	$44K	$157.17	3.2× median	Above 75th
15	1093232506	$42K	$43.79	0.9× median	Below Median
16	1629637475	$36K	$66.45	1.4× median	Above Median
17	Henry Ford Health System Detroit, MI · General Acute Care Hospital	$36K	$126.95	2.6× median	Above 75th
18	1861060733	$32K	$44.03	0.9× median	Below Median
19	1417909854	$30K	$55.91	1.1× median	Above Median
20	1326049388	$28K	$31.46	0.6× median	Below Median

Showing top 20 of 130 providers billing this code

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