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#5112 of 11K

52005

HCPCS Procedure Code

HCPCS code 52005 is the #5,112 most-billed Medicaid procedure code, with $287K in payments across 1,543 claims from 2018–2024. The national median cost per claim is $120.56. Costs vary widely — the 90th percentile is $787.40 per claim, 6.5× the median.

Total Paid

$287K

0.00% of all spending

Total Claims

1,543

Providers

16

Avg Cost/Claim

$186

National Cost Distribution

How much do providers bill per claim for 52005? Based on 14 providers billing this code nationally.

Median

$120.56

Average

$276.01

Std Dev

$337.96

Max

$1,087.57

Percentile Distribution (Cost per Claim)

p10
$23.89
p25
$62.32
Median
$120.56
p75
$315.12
p90
$787.40
p95
$951.74
p99
$1,060.40

50% of providers bill between $62.32 and $315.12 per claim for this code.

90% bill between $23.89 and $787.40.

Top 1% bill above $1,060.40.

About This Procedure

HCPCS code 52005 was billed by 16 providers across 1,543 claims, totaling $287K in Medicaid payments from 2018–2024. This code was used for 1,423 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$120.56

Providers Billing

14

National Spending

$287K

Avg/Median Ratio

2.29×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for 52005

#ProviderTotal Paid
1The Cooper Health System

Camden, NJ · General Acute Care Hospital

$122K
21093736795$37K
31295023547$34K
41932411493$31K
51841229705$23K
61104899319$16K
71124588793$9K
81932381530$7K
9Umass Memorial Medical Center, Inc.

Worcester, MA · General Acute Care Hospital

$4K
101649217514$2K
111740204379$2K
121710931985$1K
131285930016$888
141528149218$228
151184197683$0
161487680518$0

Showing top 16 of 16 providers billing this code

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