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#5049 of 11K

55180

HCPCS Procedure Code

HCPCS code 55180 is the #5,049 most-billed Medicaid procedure code, with $307K in payments across 336 claims from 2018–2024. The national median cost per claim is $252.08. Costs vary widely — the 90th percentile is $2,871.73 per claim, 11.4× the median.

Total Paid

$307K

0.00% of all spending

Total Claims

336

Providers

5

Avg Cost/Claim

$915

National Cost Distribution

How much do providers bill per claim for 55180? Based on 5 providers billing this code nationally.

Median

$252.08

Average

$1,168.77

Std Dev

$1,576.63

Max

$3,809.36

Percentile Distribution (Cost per Claim)

p10
$153.94
p25
$181.65
Median
$252.08
p75
$1,465.27
p90
$2,871.73
p95
$3,340.55
p99
$3,715.60

50% of providers bill between $181.65 and $1,465.27 per claim for this code.

90% bill between $153.94 and $2,871.73.

Top 1% bill above $3,715.60.

About This Procedure

HCPCS code 55180 was billed by 5 providers across 336 claims, totaling $307K in Medicaid payments from 2018–2024. This code was used for 292 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$252.08

Providers Billing

5

National Spending

$307K

Avg/Median Ratio

4.64×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for 55180

#ProviderTotal Paid
11740233782$202K
21184280695$49K
31609275585$47K
41932543246$8K
51487851275$2K

Showing top 5 of 5 providers billing this code

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