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#4728 of 11K

58120

HCPCS Procedure Code

HCPCS code 58120 is the #4,728 most-billed Medicaid procedure code, with $430K in payments across 2,604 claims from 2018–2024. The national median cost per claim is $99.40. Costs vary widely — the 90th percentile is $233.51 per claim, 2.3× the median.

Total Paid

$430K

0.00% of all spending

Total Claims

2,604

Providers

20

Avg Cost/Claim

$165

National Cost Distribution

How much do providers bill per claim for 58120? Based on 18 providers billing this code nationally.

Median

$99.40

Average

$152.53

Std Dev

$167.43

Max

$775.58

Percentile Distribution (Cost per Claim)

p10
$50.88
p25
$74.53
Median
$99.40
p75
$157.17
p90
$233.51
p95
$343.35
p99
$689.13

50% of providers bill between $74.53 and $157.17 per claim for this code.

90% bill between $50.88 and $233.51.

Top 1% bill above $689.13.

About This Procedure

HCPCS code 58120 was billed by 20 providers across 2,604 claims, totaling $430K in Medicaid payments from 2018–2024. This code was used for 2,040 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$99.40

Providers Billing

18

National Spending

$430K

Avg/Median Ratio

1.53×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for 58120

#ProviderTotal Paid
11164848453$246K
21679635031$75K
31801196498$48K
41073505764$16K
51649237827$11K
61629107636$5K
71316948540$4K
81114022431$4K
91023308145$3K
101457482192$3K
111427042332$3K
121598924458$3K
131841402914$2K
141801874565$2K
151912334533$2K
161598807539$2K
171225230592$1K
181336245802$1K
191831193499$0
201871065516$0

Showing top 20 of 20 providers billing this code

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