52204
HCPCS Procedure Code
HCPCS code 52204 is the #6,380 most-billed Medicaid procedure code, with $70K in payments across 418 claims from 2018–2024. The national median cost per claim is $101.99. Costs vary widely — the 90th percentile is $383.84 per claim, 3.8× the median.
Total Paid
$70K
0.00% of all spending
Total Claims
418
Providers
18
Avg Cost/Claim
$167
National Cost Distribution
How much do providers bill per claim for 52204? Based on 18 providers billing this code nationally.
Median
$101.99
Average
$166.76
Std Dev
$146.62
Max
$465.13
Percentile Distribution (Cost per Claim)
50% of providers bill between $57.56 and $259.48 per claim for this code.
90% bill between $31.87 and $383.84.
Top 1% bill above $459.88.
About This Procedure
HCPCS code 52204 was billed by 18 providers across 418 claims, totaling $70K in Medicaid payments from 2018–2024. This code was used for 365 unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$101.99
Providers Billing
18
National Spending
$70K
Avg/Median Ratio
1.64×
Moderately skewed
Top Providers Billing This Code
Ranked by total Medicaid payments for 52204
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1285873166 | $16K |
| 2 | 1043282338 | $12K |
| 3 | Southern Ohio Medical Center Portsmouth, OH · Clinical Medical Laboratory | $7K |
| 4 | 1679646061 | $6K |
| 5 | 1558452144 | $4K |
| 6 | 1841482577 | $4K |
| 7 | 1518974328 | $4K |
| 8 | 1356428429 | $4K |
| 9 | 1659322022 | $3K |
| 10 | 1124339403 | $2K |
| 11 | 1295223279 | $1K |
| 12 | 1962548149 | $1K |
| 13 | 1326093147 | $971 |
| 14 | 1457467227 | $894 |
| 15 | 1598216152 | $889 |
| 16 | 1871248740 | $796 |
| 17 | 1740204379 | $401 |
| 18 | 1285930016 | $363 |
Showing top 18 of 18 providers billing this code