#2784 of 11K

65855

HCPCS Procedure Code

HCPCS code 65855 is the #2,784 most-billed Medicaid procedure code, with $3.7M in payments across 35K claims from 2018–2024. The national median cost per claim is $104.20. Costs vary widely — the 90th percentile is $265.29 per claim, 2.5× the median.

Total Paid

$3.7M

0.00% of all spending

Total Claims

35K

Providers

132

Avg Cost/Claim

$106

National Cost Distribution

How much do providers bill per claim for 65855? Based on 132 providers billing this code nationally.

Median

$104.20

Average

$130.56

Std Dev

$99.57

Max

$567.22

Percentile Distribution (Cost per Claim)

p10

$33.10

p25

$59.20

Median

$104.20

p75

$176.90

p90

$265.29

p95

$314.48

p99

$423.45

50% of providers bill between $59.20 and $176.90 per claim for this code.

90% bill between $33.10 and $265.29.

Top 1% bill above $423.45.

About This Procedure

HCPCS code 65855 was billed by 132 providers across 35K claims, totaling $3.7M in Medicaid payments from 2018–2024. This code was used for 25K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$104.20

Providers Billing

132

National Spending

$3.7M

Avg/Median Ratio

1.25×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 65855

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1215207683	$312K	$183.41	1.8× median	Above 75th
2	1205878915	$290K	$155.39	1.5× median	Above Median
3	1528081148	$230K	$194.67	1.9× median	Above 75th
4	1124001151	$188K	$119.19	1.1× median	Above Median
5	1417953134	$180K	$236.27	2.3× median	Above 75th
6	1851332241	$149K	$41.27	0.4× median	Below Median
7	1043206469	$135K	$49.51	0.5× median	Below Median
8	1821336421	$134K	$42.72	0.4× median	Below Median
9	1467611558	$108K	$208.26	2.0× median	Above 75th
10	1851305817	$106K	$105.06	1.0× median	Above Median
11	1134101256	$100K	$360.19	3.5× median	Top 10%
12	1861435174	$88K	$126.36	1.2× median	Above Median
13	1124264007	$81K	$166.57	1.6× median	Above Median
14	1316961998	$72K	$251.05	2.4× median	Above 75th
15	1710962865	$65K	$59.28	0.6× median	Below Median
16	1427536325	$60K	$286.81	2.8× median	Top 10%
17	1558458455	$58K	$101.11	1.0× median	Below Median
18	1184675704	$57K	$184.10	1.8× median	Above 75th
19	1922280965	$47K	$174.98	1.7× median	Above Median
20	1144219379	$45K	$292.96	2.8× median	Top 10%

Showing top 20 of 132 providers billing this code

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