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#5624 of 11K

4255F

HCPCS Procedure Code

HCPCS code 4255F is the #5,624 most-billed Medicaid procedure code, with $166K in payments across 98K claims from 2018–2024. The national median cost per claim is $0.56. Costs vary widely — the 90th percentile is $24.08 per claim, 43.0× the median.

Total Paid

$166K

0.00% of all spending

Total Claims

98K

Providers

52

Avg Cost/Claim

$2

National Cost Distribution

How much do providers bill per claim for 4255F? Based on 7 providers billing this code nationally.

Median

$0.56

Average

$8.28

Std Dev

$17.74

Max

$47.96

Percentile Distribution (Cost per Claim)

p10
$0.00
p25
$0.01
Median
$0.56
p75
$4.71
p90
$24.08
p95
$36.02
p99
$45.57

50% of providers bill between $0.01 and $4.71 per claim for this code.

90% bill between $0.00 and $24.08.

Top 1% bill above $45.57.

About This Procedure

HCPCS code 4255F was billed by 52 providers across 98K claims, totaling $166K in Medicaid payments from 2018–2024. This code was used for 81K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$0.56

Providers Billing

7

National Spending

$166K

Avg/Median Ratio

14.79×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for 4255F

#ProviderTotal Paid
11720024235$146K
21518916154$19K
31811997869$913
41811442874$345
51164438578$84
61427076553$1
71720166002$0
81104825108$0
91477553311$0
101972503803$0
111588954259$0
121457420580$0
131184069874$0
141649228966$0
151821007485$0
161063742716$0
171255622247$0
181225074362$0
191164694782$0
201487677845$0

Showing top 20 of 52 providers billing this code