78580
HCPCS Procedure Code
HCPCS code 78580 is the #5,707 most-billed Medicaid procedure code, with $150K in payments across 5,295 claims from 2018–2024. The national median cost per claim is $15.95. Costs vary widely — the 90th percentile is $61.07 per claim, 3.8× the median.
Total Paid
$150K
0.00% of all spending
Total Claims
5,295
Providers
81
Avg Cost/Claim
$28
National Cost Distribution
How much do providers bill per claim for 78580? Based on 78 providers billing this code nationally.
Median
$15.95
Average
$48.48
Std Dev
$186.49
Max
$1,635.89
Percentile Distribution (Cost per Claim)
50% of providers bill between $10.17 and $21.06 per claim for this code.
90% bill between $7.58 and $61.07.
Top 1% bill above $533.46.
About This Procedure
HCPCS code 78580 was billed by 81 providers across 5,295 claims, totaling $150K in Medicaid payments from 2018–2024. This code was used for 4,861 unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$15.95
Providers Billing
78
National Spending
$150K
Avg/Median Ratio
3.04×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for 78580
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1487740957 | $43K |
| 2 | 1679529978 | $9K |
| 3 | 1144274317 | $8K |
| 4 | 1326093675 | $6K |
| 5 | 1720561186 | $5K |
| 6 | Aurora Health Care Metro, Inc. Milwaukee, WI · Internal Medicine, Hematology & Oncology | $5K |
| 7 | Kennedy University Hospital Inc. Stratford, NJ · General Acute Care Hospital | $5K |
| 8 | 1851442412 | $5K |
| 9 | 1740283324 | $4K |
| 10 | 1821099474 | $4K |
| 11 | 1669499414 | $4K |
| 12 | 1639123284 | $4K |
| 13 | Atlanticare Regional Medical Center Pomona, NJ · General Acute Care Hospital | $3K |
| 14 | 1972575892 | $3K |
| 15 | 1467405175 | $3K |
| 16 | 1376719666 | $2K |
| 17 | 1437119310 | $2K |
| 18 | 1083039200 | $2K |
| 19 | 1134178023 | $2K |
| 20 | 1922374842 | $2K |
Showing top 20 of 81 providers billing this code