#5592 of 11K

65205

HCPCS Procedure Code

HCPCS code 65205 is the #5,592 most-billed Medicaid procedure code, with $171K in payments across 14K claims from 2018–2024. The national median cost per claim is $17.91. Costs vary widely — the 90th percentile is $53.91 per claim, 3.0× the median.

Total Paid

$171K

0.00% of all spending

Total Claims

14K

Providers

Avg Cost/Claim

$12

National Cost Distribution

How much do providers bill per claim for 65205? Based on 22 providers billing this code nationally.

Median

$17.91

Average

$24.39

Std Dev

$26.11

Max

$111.98

Percentile Distribution (Cost per Claim)

p10

$3.61

p25

$8.83

Median

$17.91

p75

$26.10

p90

$53.91

p95

$71.92

p99

$103.74

50% of providers bill between $8.83 and $26.10 per claim for this code.

90% bill between $3.61 and $53.91.

Top 1% bill above $103.74.

About This Procedure

HCPCS code 65205 was billed by 23 providers across 14K claims, totaling $171K in Medicaid payments from 2018–2024. This code was used for 13K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$17.91

Providers Billing

National Spending

$171K

Avg/Median Ratio

1.36×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 65205

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1013163005	$47K	$12.52	0.7× median	Below Median
2	1760541569	$32K	$38.20	2.1× median	Above 75th
3	1588727101	$28K	$22.61	1.3× median	Above Median
4	1396887428	$13K	$8.44	0.5× median	Below Median
5	1871508440	$11K	$12.61	0.7× median	Below Median
6	1033194345	$11K	$111.98	6.3× median	Top 1%
7	1578039574	$7K	$27.08	1.5× median	Above 75th
8	1578541991	$5K	$2.70	0.2× median	Below Median
9	1063400604	$5K	$1.60	0.1× median	Below Median
10	1679635205	$2K	$15.31	0.9× median	Below Median
11	1326138710	$2K	$72.77	4.1× median	Top 10%
12	1407946288	$1K	$8.69	0.5× median	Below Median
13	1730273806	$1K	$21.97	1.2× median	Above Median
14	1225182801	$779	$55.66	3.1× median	Top 10%
15	1972539112	$709	$4.86	0.3× median	Below Median
16	1700969763	$656	$20.50	1.1× median	Above Median
17	1104968049	$635	$22.69	1.3× median	Above Median
18	1174537021	$458	$11.18	0.6× median	Below Median
19	1073536090	$426	$9.26	0.5× median	Below Median
20	1902102742	$411	$29.33	1.6× median	Above 75th

Showing top 20 of 23 providers billing this code

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