Statistical flags indicate unusual patterns — not proof of fraud or wrongdoing. Read our methodology

#793 of 11K

84520

HCPCS Procedure Code

HCPCS code 84520 is the #793 most-billed Medicaid procedure code, with $79.0M in payments across 17.1M claims from 2018–2024. The national median cost per claim is $0.89. Costs vary widely — the 90th percentile is $14.42 per claim, 16.2× the median.

Total Paid

$79.0M

0.01% of all spending

Total Claims

17.1M

Providers

4,220

Avg Cost/Claim

$5

National Cost Distribution

How much do providers bill per claim for 84520? Based on 3,104 providers billing this code nationally.

Median

$0.89

Average

$11.36

Std Dev

$35.81

Max

$339.36

Percentile Distribution (Cost per Claim)

p10
$0.02
p25
$0.13
Median
$0.89
p75
$3.10
p90
$14.42
p95
$100.49
p99
$175.42

50% of providers bill between $0.13 and $3.10 per claim for this code.

90% bill between $0.02 and $14.42.

Top 1% bill above $175.42.

About This Procedure

HCPCS code 84520 was billed by 4,220 providers across 17.1M claims, totaling $79.0M in Medicaid payments from 2018–2024. This code was used for 12.1M unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$0.89

Providers Billing

3,104

National Spending

$79.0M

Avg/Median Ratio

12.76×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for 84520

#ProviderTotal Paid
1Mid Atlantic Pemanente Medical Group

Rockville, MD · Health Maintenance Organization

$1.2M
2Renal Care Group Of The Southeast Inc.

Pensacola, FL · Clinic/Center End-Stage Renal Disease (ESRD) Treatment

$1.0M
31790897551$944K
41588065510$908K
51609988450$867K
61437168440$838K
71376588046$825K
81225436199$806K
91083726822$789K
101780771998$771K
111912372293$765K
121821520735$740K
131811009665$704K
141336251198$689K
151457449282$687K
161316059165$680K
171801908652$660K
181750493508$660K
191356453195$656K
201528170388$646K

Showing top 20 of 4,220 providers billing this code