58100
HCPCS Procedure Code
HCPCS code 58100 is the #2,544 most-billed Medicaid procedure code, with $5.1M in payments across 54K claims from 2018–2024. The national median cost per claim is $54.64. Costs vary widely — the 90th percentile is $220.51 per claim, 4.0× the median.
Total Paid
$5.1M
0.00% of all spending
Total Claims
54K
Providers
220
Avg Cost/Claim
$94
National Cost Distribution
How much do providers bill per claim for 58100? Based on 191 providers billing this code nationally.
Median
$54.64
Average
$96.90
Std Dev
$115.37
Max
$749.54
Percentile Distribution (Cost per Claim)
50% of providers bill between $33.93 and $108.35 per claim for this code.
90% bill between $12.81 and $220.51.
Top 1% bill above $599.21.
About This Procedure
HCPCS code 58100 was billed by 220 providers across 54K claims, totaling $5.1M in Medicaid payments from 2018–2024. This code was used for 45K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$54.64
Providers Billing
191
National Spending
$5.1M
Avg/Median Ratio
1.77×
Moderately skewed
Top Providers Billing This Code
Ranked by total Medicaid payments for 58100
| # | Provider | Total Paid |
|---|---|---|
| 1 | The New York And Presbyterian Hospital New York, NY · General Acute Care Hospital | $396K |
| 2 | Rector & Visitors Of The University Of Virginia Charlottesville, VA · General Acute Care Hospital | $386K |
| 3 | Umass Memorial Medical Center, Inc. Worcester, MA · General Acute Care Hospital | $343K |
| 4 | Brigham & Womens Hospital Inc. Boston, MA · General Acute Care Hospital | $306K |
| 5 | Boston Medical Center Corporation Boston, MA · General Acute Care Hospital | $277K |
| 6 | The Cleveland Clinic Foundation Cleveland, OH · General Acute Care Hospital | $233K |
| 7 | Bronxcare Health System Bronx, NY · General Acute Care Hospital | $199K |
| 8 | Montefiore Medical Center Bronx, NY · General Acute Care Hospital | $153K |
| 9 | Medical Associates Of Ebnhc East Boston, MA · Clinic/Center, Community Health | $149K |
| 10 | The Metrohealth System Cleveland, OH · General Acute Care Hospital | $125K |
| 11 | Regents Of The University Of Michigan Ann Arbor, MI · Clinic/Center, End-Stage Renal Disease (ESRD) Treatment | $114K |
| 12 | Virginia Commonwealth University Health System Authority Richmond, VA · General Acute Care Hospital | $113K |
| 13 | 1457540056 | $92K |
| 14 | The General Hospital Corporation Boston, MA · General Acute Care Hospital | $88K |
| 15 | 1578580650 | $88K |
| 16 | Cambridge Public Health Commission Cambridge, MA · General Acute Care Hospital | $87K |
| 17 | The New York And Presbyterian Hospital New York, NY · General Acute Care Hospital | $80K |
| 18 | Mount Sinai Hospital New York, NY · Ambulance | $75K |
| 19 | Spectrum Health Primary Care Partners Grand Rapids, MI · Psychologist, Clinical Child & Adolescent | $72K |
| 20 | 1902197130 | $65K |
Showing top 20 of 220 providers billing this code