#1880 of 11K

20552

HCPCS Procedure Code

HCPCS code 20552 is the #1,880 most-billed Medicaid procedure code, with $12.3M in payments across 320K claims from 2018–2024. The national median cost per claim is $23.11. Costs vary widely — the 90th percentile is $88.39 per claim, 3.8× the median.

Total Paid

$12.3M

0.00% of all spending

Total Claims

320K

Providers

701

Avg Cost/Claim

$38

National Cost Distribution

How much do providers bill per claim for 20552? Based on 670 providers billing this code nationally.

Median

$23.11

Average

$40.81

Std Dev

$78.40

Max

$1,030.25

Percentile Distribution (Cost per Claim)

p10

$7.53

p25

$14.47

Median

$23.11

p75

$35.96

p90

$88.39

p95

$145.08

p99

$267.04

50% of providers bill between $14.47 and $35.96 per claim for this code.

90% bill between $7.53 and $88.39.

Top 1% bill above $267.04.

About This Procedure

HCPCS code 20552 was billed by 701 providers across 320K claims, totaling $12.3M in Medicaid payments from 2018–2024. This code was used for 257K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$23.11

Providers Billing

670

National Spending

$12.3M

Avg/Median Ratio

1.77×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for 20552

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	Ahava Medical And Rehabilitation Center, Llc Brooklyn, NY · Rehabilitation Practitioner	$1.4M	$181.88	7.9× median	Top 10%
2	Berkshire Medical Center, Inc Pittsfield, MA · General Acute Care Hospital	$798K	$78.84	3.4× median	Above 75th
3	1558356741	$758K	$90.36	3.9× median	Top 10%
4	Unm Hospital Albuquerque, NM · General Acute Care Hospital	$497K	$133.34	5.8× median	Top 10%
5	1598112294	$302K	$40.34	1.7× median	Above 75th
6	Baystate Medical Center Inc Springfield, MA · General Acute Care Hospital	$292K	$190.02	8.2× median	Top 10%
7	Rector & Visitors Of The University Of Virginia Charlottesville, VA · General Acute Care Hospital	$260K	$274.60	11.9× median	Top 1%
8	Alaska Native Tribal Health Consortium Anchorage, AK · General Acute Care Hospital	$220K	$516.37	22.3× median	Top 1%
9	Yale New Haven Hospital New Haven, CT · General Acute Care Hospital	$195K	$181.52	7.9× median	Top 10%
10	1396144341	$195K	$31.00	1.3× median	Above Median
11	1265727762	$190K	$51.76	2.2× median	Above 75th
12	1477549756	$190K	$160.08	6.9× median	Top 10%
13	1144693607	$188K	$176.40	7.6× median	Top 10%
14	1154633980	$175K	$21.11	0.9× median	Below Median
15	1740478502	$160K	$36.32	1.6× median	Above 75th
16	Virginia Commonwealth University Health System Authority Richmond, VA · General Acute Care Hospital	$155K	$263.65	11.4× median	Top 10%
17	1154376788	$147K	$21.92	0.9× median	Below Median
18	1033296231	$144K	$48.47	2.1× median	Above 75th
19	1568446755	$135K	$66.33	2.9× median	Above 75th
20	1477781425	$131K	$24.34	1.1× median	Above Median

Showing top 20 of 701 providers billing this code

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20553$36.3M 20550$16.3M 20551$1.8M 20561$272K 20560$122K

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