Statistical flags indicate unusual patterns — not proof of fraud or wrongdoing. Read our methodology

#3208 of 11K

25605

HCPCS Procedure Code

HCPCS code 25605 is the #3,208 most-billed Medicaid procedure code, with $2.2M in payments across 7,474 claims from 2018–2024. The national median cost per claim is $388.59.

Total Paid

$2.2M

0.00% of all spending

Total Claims

7,474

Providers

52

Avg Cost/Claim

$298

National Cost Distribution

How much do providers bill per claim for 25605? Based on 49 providers billing this code nationally.

Median

$388.59

Average

$405.68

Std Dev

$267.39

Max

$1,253.45

Percentile Distribution (Cost per Claim)

p10
$63.57
p25
$220.70
Median
$388.59
p75
$522.09
p90
$759.06
p95
$850.37
p99
$1,107.22

50% of providers bill between $220.70 and $522.09 per claim for this code.

90% bill between $63.57 and $759.06.

Top 1% bill above $1,107.22.

About This Procedure

HCPCS code 25605 was billed by 52 providers across 7,474 claims, totaling $2.2M in Medicaid payments from 2018–2024. This code was used for 6,384 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$388.59

Providers Billing

49

National Spending

$2.2M

Avg/Median Ratio

1.04×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 25605

#ProviderTotal Paid
1Phoenix Children's Hospital

Phoenix, AZ · General Acute Care Hospital Children

$266K
21942300918$249K
3Spectrum Health Hospitals

Grand Rapids, MI · General Acute Care Hospital

$230K
4Yale New Haven Hospital

New Haven, CT · General Acute Care Hospital

$228K
5Scottish Rite Children's Medical Center

Atlanta, GA · Pediatrics Pediatric Hematology-Oncology

$177K
6Long Island Jewish Medical Center

New Hyde Park, NY · General Acute Care Hospital

$134K
7Connecticut Children's Medical Center

Hartford, CT · General Acute Care Hospital, Children

$107K
8University Of Kentucky

Lexington, KY · General Acute Care Hospital

$92K
9Children's Hospital Of Wisconsin, Inc.

Milwaukee, WI · Dentist, Pediatric Dentistry

$73K
10Vhs Childrens Hospital Of Michigan Inc

Detroit, MI · Clinic/Center, Ambulatory Surgical

$64K
111306952726$59K
12Norton Hospitals Inc

Louisville, KY · General Acute Care Hospital

$50K
13Suny Health Science Center At Syracuse

Syracuse, NY · General Acute Care Hospital

$41K
141649726738$39K
15Norton Hospitals, Inc

Louisville, KY · General Acute Care Hospital

$37K
161598717480$35K
171245365196$30K
18The New York And Presbyterian Hospital

New York, NY · General Acute Care Hospital

$25K
19Children's Hospital & Research Center At Oakland

Oakland, CA · General Acute Care Hospital

$25K
20Unm Hospital

Albuquerque, NM · General Acute Care Hospital

$24K

Showing top 20 of 52 providers billing this code

Related Procedures