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#6256 of 11K

54065

HCPCS Procedure Code

HCPCS code 54065 is the #6,256 most-billed Medicaid procedure code, with $80K in payments across 510 claims from 2018–2024. The national median cost per claim is $150.95.

Total Paid

$80K

0.00% of all spending

Total Claims

510

Providers

3

Avg Cost/Claim

$157

National Cost Distribution

How much do providers bill per claim for 54065? Based on 3 providers billing this code nationally.

Median

$150.95

Average

$155.25

Std Dev

$76.64

Max

$233.95

Percentile Distribution (Cost per Claim)

p10
$94.86
p25
$115.89
Median
$150.95
p75
$192.45
p90
$217.35
p95
$225.65
p99
$232.29

50% of providers bill between $115.89 and $192.45 per claim for this code.

90% bill between $94.86 and $217.35.

Top 1% bill above $232.29.

About This Procedure

HCPCS code 54065 was billed by 3 providers across 510 claims, totaling $80K in Medicaid payments from 2018–2024. This code was used for 385 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$150.95

Providers Billing

3

National Spending

$80K

Avg/Median Ratio

1.03×

Normal distribution

Provider Coverage

We have 3 providers billing this code in our dataset. Individual provider breakdowns are available for top-spending procedure codes.

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