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#5098 of 11K

57420

HCPCS Procedure Code

HCPCS code 57420 is the #5,098 most-billed Medicaid procedure code, with $292K in payments across 638 claims from 2018–2024. The national median cost per claim is $60.03. Costs vary widely — the 90th percentile is $758.01 per claim, 12.6× the median.

Total Paid

$292K

0.00% of all spending

Total Claims

638

Providers

8

Avg Cost/Claim

$458

National Cost Distribution

How much do providers bill per claim for 57420? Based on 8 providers billing this code nationally.

Median

$60.03

Average

$254.73

Std Dev

$398.35

Max

$1,114.93

Percentile Distribution (Cost per Claim)

p10
$30.04
p25
$38.91
Median
$60.03
p75
$227.14
p90
$758.01
p95
$936.47
p99
$1,079.24

50% of providers bill between $38.91 and $227.14 per claim for this code.

90% bill between $30.04 and $758.01.

Top 1% bill above $1,079.24.

About This Procedure

HCPCS code 57420 was billed by 8 providers across 638 claims, totaling $292K in Medicaid payments from 2018–2024. This code was used for 543 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$60.03

Providers Billing

8

National Spending

$292K

Avg/Median Ratio

4.24×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for 57420

#ProviderTotal Paid
11063489342$198K
2Virginia Commonwealth University Health System Authority

Richmond, VA · General Acute Care Hospital

$76K
31467535450$6K
41164736401$4K
51306089206$3K
61265524821$3K
71316938921$1K
81578587671$496

Showing top 8 of 8 providers billing this code