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#4268 of 11K

65426

HCPCS Procedure Code

HCPCS code 65426 is the #4,268 most-billed Medicaid procedure code, with $702K in payments across 1,169 claims from 2018–2024. The national median cost per claim is $578.99. Costs vary widely — the 90th percentile is $1,243.70 per claim, 2.1× the median.

Total Paid

$702K

0.00% of all spending

Total Claims

1,169

Providers

27

Avg Cost/Claim

$601

National Cost Distribution

How much do providers bill per claim for 65426? Based on 27 providers billing this code nationally.

Median

$578.99

Average

$710.39

Std Dev

$513.13

Max

$2,371.74

Percentile Distribution (Cost per Claim)

p10
$230.12
p25
$387.08
Median
$578.99
p75
$903.29
p90
$1,243.70
p95
$1,609.43
p99
$2,193.60

50% of providers bill between $387.08 and $903.29 per claim for this code.

90% bill between $230.12 and $1,243.70.

Top 1% bill above $2,193.60.

About This Procedure

HCPCS code 65426 was billed by 27 providers across 1,169 claims, totaling $702K in Medicaid payments from 2018–2024. This code was used for 1,075 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$578.99

Providers Billing

27

National Spending

$702K

Avg/Median Ratio

1.23×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 65426

#ProviderTotal Paid
11649218009$77K
21962422709$64K
31245251222$62K
41033222989$58K
51013449297$51K
61518057546$44K
71457515181$41K
81538159397$39K
91720407273$33K
101295793974$28K
111730112178$25K
121639101751$20K
131114033404$20K
141659609311$19K
151275594012$17K
161851673511$16K
171376639575$16K
181295882587$16K
191376641670$14K
201053416818$10K

Showing top 20 of 27 providers billing this code

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