#1999 of 11K

A5512

Diabetic shoe insert, custom molded, each

Diabetic shoe insert, custom molded, each is the #1,999 most-billed Medicaid procedure code, with $10.3M in payments across 437K claims from 2018–2024. The national median cost per claim is $24.01. Costs vary widely — the 90th percentile is $59.37 per claim, 2.5× the median.

Total Paid

$10.3M

0.00% of all spending

Total Claims

437K

Providers

658

Avg Cost/Claim

$24

National Cost Distribution

How much do providers bill per claim for A5512? Based on 604 providers billing this code nationally.

Median

$24.01

Average

$29.33

Std Dev

$25.69

Max

$183.22

Percentile Distribution (Cost per Claim)

p10

$2.85

p25

$11.86

Median

$24.01

p75

$40.04

p90

$59.37

p95

$71.85

p99

$130.46

50% of providers bill between $11.86 and $40.04 per claim for this code.

90% bill between $2.85 and $59.37.

Top 1% bill above $130.46.

About This Procedure

HCPCS code A5512 (Diabetic shoe insert, custom molded, each) was billed by 658 providers across 437K claims, totaling $10.3M in Medicaid payments from 2018–2024. This code was used for 257K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$24.01

Providers Billing

604

National Spending

$10.3M

Avg/Median Ratio

1.22×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for A5512

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	Integra Partners Llc Troy, MI · Orthotic Fitter	$644K	$37.38	1.6× median	Above Median
2	1972550028	$383K	$49.62	2.1× median	Above 75th
3	1659365849	$331K	$26.15	1.1× median	Above Median
4	1336456193	$263K	$28.17	1.2× median	Above Median
5	1629015904	$247K	$19.28	0.8× median	Below Median
6	1992832075	$239K	$21.09	0.9× median	Below Median
7	1427058650	$226K	$55.57	2.3× median	Above 75th
8	1972894863	$225K	$13.23	0.6× median	Below Median
9	1144205766	$223K	$55.83	2.3× median	Above 75th
10	1912955881	$200K	$36.48	1.5× median	Above Median
11	1801858378	$199K	$27.49	1.1× median	Above Median
12	1376576355	$186K	$29.92	1.2× median	Above Median
13	1164593232	$176K	$61.41	2.6× median	Top 10%
14	1649212572	$159K	$58.41	2.4× median	Above 75th
15	1679617229	$135K	$17.89	0.7× median	Below Median
16	1477684132	$133K	$24.40	1.0× median	Above Median
17	1093901100	$126K	$42.29	1.8× median	Above 75th
18	1164586103	$122K	$32.49	1.4× median	Above Median
19	1063879344	$121K	$67.98	2.8× median	Top 10%
20	1558370023	$115K	$55.52	2.3× median	Above 75th

Showing top 20 of 658 providers billing this code

Related Procedures

A5513Diabetic therapeutic shoe, each, custom molded$12.3M A5514$3.3M A5503$169K A5507$38K A5505$14K

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