#4904 of 11K

D5422

HCPCS Procedure Code

HCPCS code D5422 is the #4,904 most-billed Medicaid procedure code, with $359K in payments across 12K claims from 2018–2024. The national median cost per claim is $32.43.

Total Paid

$359K

0.00% of all spending

Total Claims

12K

Providers

Avg Cost/Claim

$30

National Cost Distribution

How much do providers bill per claim for D5422? Based on 47 providers billing this code nationally.

Median

$32.43

Average

$27.71

Std Dev

$11.67

Max

$42.69

Percentile Distribution (Cost per Claim)

p10

$9.74

p25

$19.18

Median

$32.43

p75

$35.07

p90

$38.97

p95

$40.48

p99

$42.14

50% of providers bill between $19.18 and $35.07 per claim for this code.

90% bill between $9.74 and $38.97.

Top 1% bill above $42.14.

About This Procedure

HCPCS code D5422 was billed by 52 providers across 12K claims, totaling $359K in Medicaid payments from 2018–2024. This code was used for 11K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$32.43

Providers Billing

National Spending

$359K

Avg/Median Ratio

0.85×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for D5422

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	My Community Dental Centers Inc Petoskey, MI · Dentist, Dental Public Health	$66K	$42.69	1.3× median	Top 1%
2	1407146111	$48K	$33.84	1.0× median	Above Median
3	1073679189	$35K	$34.80	1.1× median	Above Median
4	1710036181	$34K	$32.43	1.0× median	Above Median
5	1437584349	$22K	$26.44	0.8× median	Below Median
6	1447441720	$21K	$40.69	1.3× median	Top 10%
7	1699028597	$14K	$38.81	1.2× median	Above 75th
8	1912430778	$12K	$34.80	1.1× median	Above Median
9	1942717343	$12K	$31.88	1.0× median	Below Median
10	1134420110	$11K	$38.85	1.2× median	Above 75th
11	1689947269	$10K	$36.67	1.1× median	Above 75th
12	1548779135	$8K	$38.78	1.2× median	Above 75th
13	1902959901	$8K	$35.00	1.1× median	Above Median
14	1225151541	$8K	$34.22	1.1× median	Above Median
15	1477678134	$7K	$27.87	0.9× median	Below Median
16	1932552080	$5K	$38.63	1.2× median	Above 75th
17	1366692824	$5K	$41.49	1.3× median	Top 10%
18	1699006296	$4K	$14.90	0.5× median	Below Median
19	1811137813	$4K	$30.83	1.0× median	Below Median
20	1205053899	$3K	$26.92	0.8× median	Below Median

Showing top 20 of 52 providers billing this code

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