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#2968 of 11K

20605

HCPCS Procedure Code

HCPCS code 20605 is the #2,968 most-billed Medicaid procedure code, with $2.9M in payments across 92K claims from 2018–2024. The national median cost per claim is $26.39. Costs vary widely — the 90th percentile is $135.97 per claim, 5.2× the median.

Total Paid

$2.9M

0.00% of all spending

Total Claims

92K

Providers

276

Avg Cost/Claim

$31

National Cost Distribution

How much do providers bill per claim for 20605? Based on 273 providers billing this code nationally.

Median

$26.39

Average

$46.58

Std Dev

$62.38

Max

$507.34

Percentile Distribution (Cost per Claim)

p10
$7.05
p25
$14.75
Median
$26.39
p75
$41.34
p90
$135.97
p95
$169.43
p99
$249.70

50% of providers bill between $14.75 and $41.34 per claim for this code.

90% bill between $7.05 and $135.97.

Top 1% bill above $249.70.

About This Procedure

HCPCS code 20605 was billed by 276 providers across 92K claims, totaling $2.9M in Medicaid payments from 2018–2024. This code was used for 66K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$26.39

Providers Billing

273

National Spending

$2.9M

Avg/Median Ratio

1.77×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for 20605

#ProviderTotal Paid
1Rector & Visitors Of The University Of Virginia

Charlottesville, VA · General Acute Care Hospital

$282K
2Virginia Commonwealth University Health System Authority

Richmond, VA · General Acute Care Hospital

$133K
31609231158$118K
41164442182$114K
5Our Lady Of The Lake Hospital Inc.

Baton Rouge, LA · General Acute Care Hospital

$113K
6The Cleveland Clinic Foundation

Cleveland, OH · General Acute Care Hospital

$95K
7Boston Medical Center Corporation

Boston, MA · General Acute Care Hospital

$91K
81528462694$86K
9The Metrohealth System

Cleveland, OH · General Acute Care Hospital

$82K
10Medstar Washington Hospital Center

Washington, DC · General Acute Care Hospital

$77K
111073177267$72K
12Yale New Haven Hospital

New Haven, CT · General Acute Care Hospital

$62K
13Arthritis & Rheumatology Associates Of South Jersey Pc

Vineland, NJ · Internal Medicine Rheumatology

$61K
141407898299$61K
151144412149$55K
161821158569$49K
171073880936$48K
181023415288$47K
191841846813$44K
201033548581$39K

Showing top 20 of 276 providers billing this code