#2947 of 11K

D5225

HCPCS Procedure Code

HCPCS code D5225 is the #2,947 most-billed Medicaid procedure code, with $3.0M in payments across 4K claims from 2018–2024. The national median cost per claim is $769.48.

Total Paid

$3.0M

0.00% of all spending

Total Claims

Providers

Avg Cost/Claim

$680

National Cost Distribution

How much do providers bill per claim for D5225? Based on 34 providers billing this code nationally.

Median

$769.48

Average

$834.25

Std Dev

$292.18

Max

$1,458.39

Percentile Distribution (Cost per Claim)

p10

$525.35

p25

$633.92

Median

$769.48

p75

$990.28

p90

$1,319.34

p95

$1,428.21

p99

$1,456.31

50% of providers bill between $633.92 and $990.28 per claim for this code.

90% bill between $525.35 and $1,319.34.

Top 1% bill above $1,456.31.

About This Procedure

HCPCS code D5225 was billed by 37 providers across 4K claims, totaling $3.0M in Medicaid payments from 2018–2024. This code was used for 4K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$769.48

Providers Billing

National Spending

$3.0M

Avg/Median Ratio

1.08×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for D5225

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	My Community Dental Centers Inc Petoskey, MI · Dentist, Dental Public Health	$694K	$500.64	0.7× median	Below Median
2	1124164926	$310K	$742.38	1.0× median	Below Median
3	1124897772	$254K	$748.16	1.0× median	Below Median
4	1790006385	$211K	$797.97	1.0× median	Above Median
5	1629538988	$210K	$817.08	1.1× median	Above Median
6	1265662043	$182K	$564.00	0.7× median	Below Median
7	1689779282	$172K	$1,011.51	1.3× median	Above 75th
8	1871282061	$116K	$1,375.96	1.8× median	Top 10%
9	1437320520	$97K	$597.72	0.8× median	Below Median
10	1447441720	$85K	$832.43	1.1× median	Above Median
11	1316475304	$67K	$743.42	1.0× median	Below Median
12	1588118434	$64K	$1,452.08	1.9× median	Top 10%
13	1376941773	$61K	$572.14	0.7× median	Below Median
14	1558635607	$51K	$1,187.21	1.5× median	Above 75th
15	1811135288	$44K	$1,139.72	1.5× median	Above 75th
16	1811012826	$41K	$660.59	0.9× median	Below Median
17	1407392186	$36K	$1,458.39	1.9× median	Top 1%
18	1356987796	$33K	$882.16	1.1× median	Above Median
19	1477245207	$31K	$641.90	0.8× median	Below Median
20	1477632289	$26K	$445.32	0.6× median	Below Median

Showing top 20 of 37 providers billing this code

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D5226$3.1M D5227$74K D5222$31K D5221$12K D5228$7K

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