#4394 of 11K

58563

HCPCS Procedure Code

HCPCS code 58563 is the #4,394 most-billed Medicaid procedure code, with $616K in payments across 1K claims from 2018–2024. The national median cost per claim is $991.85. Costs vary widely — the 90th percentile is $2,153.88 per claim, 2.2× the median.

Total Paid

$616K

0.00% of all spending

Total Claims

Providers

Avg Cost/Claim

$503

National Cost Distribution

How much do providers bill per claim for 58563? Based on 17 providers billing this code nationally.

Median

$991.85

Average

$1,052.33

Std Dev

$807.70

Max

$2,540.45

Percentile Distribution (Cost per Claim)

p10

$108.18

p25

$439.57

Median

$991.85

p75

$1,522.62

p90

$2,153.88

p95

$2,461.42

p99

$2,524.64

50% of providers bill between $439.57 and $1,522.62 per claim for this code.

90% bill between $108.18 and $2,153.88.

Top 1% bill above $2,524.64.

About This Procedure

HCPCS code 58563 was billed by 18 providers across 1K claims, totaling $616K in Medicaid payments from 2018–2024. This code was used for 1K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$991.85

Providers Billing

National Spending

$616K

Avg/Median Ratio

1.06×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 58563

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	Dayton Osteopathic Hospital Dayton, OH · General Acute Care Hospital	$154K	$819.34	0.8× median	Below Median
2	1639267214	$111K	$1,522.62	1.5× median	Above 75th
3	Norton Hospitals Inc Louisville, KY · General Acute Care Hospital	$69K	$2,540.45	2.6× median	Top 1%
4	1679879589	$48K	$82.16	0.1× median	Below Median
5	1770581894	$46K	$1,445.67	1.5× median	Above Median
6	1043293608	$29K	$2,441.66	2.5× median	Top 10%
7	1396394961	$29K	$439.64	0.4× median	Below Median
8	Ashland Hospital Corporation Ashland, KY · Clinic/Center, Rural Health	$26K	$1,962.03	2.0× median	Above 75th
9	1275619736	$22K	$848.68	0.9× median	Below Median
10	Presbyterian Healthcare Services Albuquerque, NM · Emergency Medicine	$22K	$1,834.27	1.8× median	Above 75th
11	Bethesda Hospital Inc Cincinnati, OH · General Acute Care Hospital	$20K	$1,130.08	1.1× median	Above Median
12	Southern Ohio Medical Center Portsmouth, OH · Clinical Medical Laboratory	$17K	$991.85	1.0× median	Above Median
13	1265539498	$13K	$1,066.01	1.1× median	Above Median
14	1770581233	$6K	$439.57	0.4× median	Below Median
15	1699704254	$2K	$163.33	0.2× median	Below Median
16	1710125430	$2K	$125.53	0.1× median	Below Median
17	1821002007	$660	$36.67	0.0× median	Below Median
18	Community Physicians Of Indiana Inc Indianapolis, IN · Internal Medicine	$0	$0.00	0.0× median	Below Median

Showing top 18 of 18 providers billing this code

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