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#7271 of 11K

D5511

HCPCS Procedure Code

HCPCS code D5511 is the #7,271 most-billed Medicaid procedure code, with $23K in payments across 404 claims from 2018–2024. The national median cost per claim is $48.94.

Total Paid

$23K

0.00% of all spending

Total Claims

404

Providers

4

Avg Cost/Claim

$56

National Cost Distribution

How much do providers bill per claim for D5511? Based on 4 providers billing this code nationally.

Median

$48.94

Average

$54.35

Std Dev

$28.87

Max

$93.29

Percentile Distribution (Cost per Claim)

p10
$30.58
p25
$37.10
Median
$48.94
p75
$66.19
p90
$82.45
p95
$87.87
p99
$92.21

50% of providers bill between $37.10 and $66.19 per claim for this code.

90% bill between $30.58 and $82.45.

Top 1% bill above $92.21.

About This Procedure

HCPCS code D5511 was billed by 4 providers across 404 claims, totaling $23K in Medicaid payments from 2018–2024. This code was used for 347 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$48.94

Providers Billing

4

National Spending

$23K

Avg/Median Ratio

1.11×

Normal distribution

Provider Coverage

We have 4 providers billing this code in our dataset. Individual provider breakdowns are available for top-spending procedure codes.