#2649 of 11K

52310

HCPCS Procedure Code

HCPCS code 52310 is the #2,649 most-billed Medicaid procedure code, with $4.4M in payments across 11K claims from 2018–2024. The national median cost per claim is $165.52. Costs vary widely — the 90th percentile is $810.95 per claim, 4.9× the median.

Total Paid

$4.4M

0.00% of all spending

Total Claims

11K

Providers

Avg Cost/Claim

$391

National Cost Distribution

How much do providers bill per claim for 52310? Based on 68 providers billing this code nationally.

Median

$165.52

Average

$319.51

Std Dev

$301.25

Max

$1,133.57

Percentile Distribution (Cost per Claim)

p10

$61.92

p25

$111.49

Median

$165.52

p75

$518.77

p90

$810.95

p95

$967.54

p99

$1,106.53

50% of providers bill between $111.49 and $518.77 per claim for this code.

90% bill between $61.92 and $810.95.

Top 1% bill above $1,106.53.

About This Procedure

HCPCS code 52310 was billed by 69 providers across 11K claims, totaling $4.4M in Medicaid payments from 2018–2024. This code was used for 10K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$165.52

Providers Billing

National Spending

$4.4M

Avg/Median Ratio

1.93×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for 52310

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1245346923	$973K	$867.80	5.2× median	Top 10%
2	1295738375	$519K	$448.33	2.7× median	Above Median
3	The Cleveland Clinic Foundation Cleveland, OH · General Acute Care Hospital	$437K	$733.75	4.4× median	Above 75th
4	Yale New Haven Hospital New Haven, CT · General Acute Care Hospital	$318K	$974.27	5.9× median	Top 10%
5	1588328918	$242K	$794.54	4.8× median	Above 75th
6	1427027416	$210K	$155.48	0.9× median	Below Median
7	1295023547	$168K	$140.65	0.8× median	Below Median
8	Virginia Commonwealth University Health System Authority Richmond, VA · General Acute Care Hospital	$145K	$849.22	5.1× median	Top 10%
9	Ashland Hospital Corporation Ashland, KY · Clinic/Center, Rural Health	$139K	$660.84	4.0× median	Above 75th
10	Umass Memorial Medical Center, Inc. Worcester, MA · General Acute Care Hospital	$139K	$554.18	3.3× median	Above 75th
11	Montefiore Medical Center Bronx, NY · General Acute Care Hospital	$124K	$1,093.21	6.6× median	Top 10%
12	University Of Wisconsin Hospitals And Clinics Authority Madison, WI · General Acute Care Hospital	$109K	$234.81	1.4× median	Above Median
13	1780631325	$93K	$151.98	0.9× median	Below Median
14	University Of California Irvine Orange, CA · General Acute Care Hospital	$83K	$263.77	1.6× median	Above Median
15	1205845740	$71K	$337.66	2.0× median	Above Median
16	1114045234	$56K	$170.34	1.0× median	Above Median
17	1366463101	$53K	$155.52	0.9× median	Below Median
18	Eastern Maine Medical Center Bangor, ME · General Acute Care Hospital	$51K	$693.22	4.2× median	Above 75th
19	1053373480	$39K	$517.60	3.1× median	Above Median
20	Regents Of The University Of Michigan Ann Arbor, MI · Clinic/Center, End-Stage Renal Disease (ESRD) Treatment	$38K	$730.03	4.4× median	Above 75th

Showing top 20 of 69 providers billing this code

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