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#4547 of 11K

55250

HCPCS Procedure Code

HCPCS code 55250 is the #4,547 most-billed Medicaid procedure code, with $522K in payments across 2,705 claims from 2018–2024. The national median cost per claim is $149.35. Costs vary widely — the 90th percentile is $1,159.39 per claim, 7.8× the median.

Total Paid

$522K

0.00% of all spending

Total Claims

2,705

Providers

15

Avg Cost/Claim

$193

National Cost Distribution

How much do providers bill per claim for 55250? Based on 14 providers billing this code nationally.

Median

$149.35

Average

$426.01

Std Dev

$460.86

Max

$1,461.23

Percentile Distribution (Cost per Claim)

p10
$144.52
p25
$148.16
Median
$149.35
p75
$613.76
p90
$1,159.39
p95
$1,392.18
p99
$1,447.42

50% of providers bill between $148.16 and $613.76 per claim for this code.

90% bill between $144.52 and $1,159.39.

Top 1% bill above $1,447.42.

About This Procedure

HCPCS code 55250 was billed by 15 providers across 2,705 claims, totaling $522K in Medicaid payments from 2018–2024. This code was used for 1,447 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$149.35

Providers Billing

14

National Spending

$522K

Avg/Median Ratio

2.85×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for 55250

#ProviderTotal Paid
1Planned Parenthood/orange And San Bernardino Counties, Inc.

Orange, CA · Clinic/Center, Ambulatory Family Planning Facility

$132K
21093969115$120K
31053311860$88K
41497780480$56K
5The Cleveland Clinic Foundation

Cleveland, OH · General Acute Care Hospital

$27K
6Akron General Medical Center

Akron, OH · General Acute Care Hospital

$20K
71669561890$15K
81114322518$15K
91679526693$11K
101003885518$11K
11Regents Of The University Of Michigan

Ann Arbor, MI · Clinic/Center, End-Stage Renal Disease (ESRD) Treatment

$9K
121750316741$7K
131033135314$7K
141295023547$2K
151730435884$0

Showing top 15 of 15 providers billing this code