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#2181 of 11K

51728

HCPCS Procedure Code

HCPCS code 51728 is the #2,181 most-billed Medicaid procedure code, with $8.1M in payments across 53K claims from 2018–2024. The national median cost per claim is $118.19. Costs vary widely — the 90th percentile is $312.38 per claim, 2.6× the median.

Total Paid

$8.1M

0.00% of all spending

Total Claims

53K

Providers

149

Avg Cost/Claim

$154

National Cost Distribution

How much do providers bill per claim for 51728? Based on 149 providers billing this code nationally.

Median

$118.19

Average

$146.95

Std Dev

$102.57

Max

$538.22

Percentile Distribution (Cost per Claim)

p10
$44.12
p25
$73.85
Median
$118.19
p75
$194.05
p90
$312.38
p95
$358.29
p99
$406.96

50% of providers bill between $73.85 and $194.05 per claim for this code.

90% bill between $44.12 and $312.38.

Top 1% bill above $406.96.

About This Procedure

HCPCS code 51728 was billed by 149 providers across 53K claims, totaling $8.1M in Medicaid payments from 2018–2024. This code was used for 51K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$118.19

Providers Billing

149

National Spending

$8.1M

Avg/Median Ratio

1.24×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 51728

#ProviderTotal Paid
11154430148$1.4M
21982910741$532K
31427027416$392K
41215940796$356K
51427022649$305K
61902999428$268K
7Norton Hospitals Inc

Louisville, KY · General Acute Care Hospital

$265K
81982933180$240K
91568599447$232K
10Rector & Visitors Of The University Of Virginia

Charlottesville, VA · General Acute Care Hospital

$216K
11Boston Medical Center Corporation

Boston, MA · General Acute Care Hospital

$212K
12Norton Hospitals, Inc

Louisville, KY · General Acute Care Hospital

$210K
131811298953$193K
141396794574$188K
15Children's Hospital Corporation

Boston, MA · Clinic/Center

$156K
161548567498$150K
171992837702$145K
181932395068$144K
19Virginia Commonwealth University Health System Authority

Richmond, VA · General Acute Care Hospital

$133K
201710973763$132K

Showing top 20 of 149 providers billing this code