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#3384 of 11K

51797

HCPCS Procedure Code

HCPCS code 51797 is the #3,384 most-billed Medicaid procedure code, with $1.8M in payments across 36K claims from 2018–2024. The national median cost per claim is $49.66. Costs vary widely — the 90th percentile is $137.05 per claim, 2.8× the median.

Total Paid

$1.8M

0.00% of all spending

Total Claims

36K

Providers

194

Avg Cost/Claim

$51

National Cost Distribution

How much do providers bill per claim for 51797? Based on 185 providers billing this code nationally.

Median

$49.66

Average

$65.15

Std Dev

$54.30

Max

$263.35

Percentile Distribution (Cost per Claim)

p10
$10.03
p25
$23.83
Median
$49.66
p75
$94.08
p90
$137.05
p95
$169.80
p99
$238.50

50% of providers bill between $23.83 and $94.08 per claim for this code.

90% bill between $10.03 and $137.05.

Top 1% bill above $238.50.

About This Procedure

HCPCS code 51797 was billed by 194 providers across 36K claims, totaling $1.8M in Medicaid payments from 2018–2024. This code was used for 34K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$49.66

Providers Billing

185

National Spending

$1.8M

Avg/Median Ratio

1.31×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 51797

#ProviderTotal Paid
1Norton Hospitals, Inc

Louisville, KY · General Acute Care Hospital

$101K
21649284100$86K
31982017760$77K
41336361831$76K
5Norton Hospitals Inc

Louisville, KY · General Acute Care Hospital

$73K
61861821787$66K
71366459570$62K
8Women & Infants Hospital Of Rhode Island

Providence, RI · Clinic/Center, Ambulatory Family Planning Facility

$59K
91477631315$57K
101619283322$54K
111376867333$40K
121326695255$39K
131063663433$37K
141215991856$36K
151710973763$35K
161003141573$33K
171942475793$33K
181932608106$31K
191235133208$30K
201417976705$29K

Showing top 20 of 194 providers billing this code

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