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#5921 of 11K

52260

HCPCS Procedure Code

HCPCS code 52260 is the #5,921 most-billed Medicaid procedure code, with $118K in payments across 479 claims from 2018–2024. The national median cost per claim is $359.45. Costs vary widely — the 90th percentile is $857.55 per claim, 2.4× the median.

Total Paid

$118K

0.00% of all spending

Total Claims

479

Providers

7

Avg Cost/Claim

$247

National Cost Distribution

How much do providers bill per claim for 52260? Based on 7 providers billing this code nationally.

Median

$359.45

Average

$388.41

Std Dev

$354.32

Max

$940.24

Percentile Distribution (Cost per Claim)

p10
$82.15
p25
$87.65
Median
$359.45
p75
$581.65
p90
$857.55
p95
$898.90
p99
$931.97

50% of providers bill between $87.65 and $581.65 per claim for this code.

90% bill between $82.15 and $857.55.

Top 1% bill above $931.97.

About This Procedure

HCPCS code 52260 was billed by 7 providers across 479 claims, totaling $118K in Medicaid payments from 2018–2024. This code was used for 425 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$359.45

Providers Billing

7

National Spending

$118K

Avg/Median Ratio

1.08×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 52260

#ProviderTotal Paid
11598868655$43K
21285930016$24K
31093736795$19K
41740488386$17K
51407877723$10K
61063663433$4K
71407995822$967

Showing top 7 of 7 providers billing this code

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