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#5162 of 11K

20561

HCPCS Procedure Code

HCPCS code 20561 is the #5,162 most-billed Medicaid procedure code, with $272K in payments across 14K claims from 2018–2024. The national median cost per claim is $21.32.

Total Paid

$272K

0.00% of all spending

Total Claims

14K

Providers

50

Avg Cost/Claim

$19

National Cost Distribution

How much do providers bill per claim for 20561? Based on 40 providers billing this code nationally.

Median

$21.32

Average

$21.09

Std Dev

$16.95

Max

$94.94

Percentile Distribution (Cost per Claim)

p10
$0.51
p25
$12.73
Median
$21.32
p75
$28.68
p90
$35.05
p95
$40.05
p99
$74.01

50% of providers bill between $12.73 and $28.68 per claim for this code.

90% bill between $0.51 and $35.05.

Top 1% bill above $74.01.

About This Procedure

HCPCS code 20561 was billed by 50 providers across 14K claims, totaling $272K in Medicaid payments from 2018–2024. This code was used for 6K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$21.32

Providers Billing

40

National Spending

$272K

Avg/Median Ratio

0.99×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 20561

#ProviderTotal Paid
11851831085$59K
21578677548$47K
31174652580$31K
41124276217$22K
51154797157$17K
6Hartford Hospital

Hartford, CT · General Acute Care Hospital

$16K
71427298140$13K
81831650654$11K
91568063352$7K
101407126303$6K
111487796793$6K
121326229287$6K
131033710827$3K
141154454650$3K
151023610763$3K
161457027336$2K
171376146639$2K
18District Hospital Partners L P

Washington, DC · Nurse Practitioner, Family

$2K
191811467517$2K
201053973644$2K

Showing top 20 of 50 providers billing this code