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#5905 of 11K

D5630

HCPCS Procedure Code

HCPCS code D5630 is the #5,905 most-billed Medicaid procedure code, with $121K in payments across 1,277 claims from 2018–2024. The national median cost per claim is $116.67.

Total Paid

$121K

0.00% of all spending

Total Claims

1,277

Providers

9

Avg Cost/Claim

$95

National Cost Distribution

How much do providers bill per claim for D5630? Based on 9 providers billing this code nationally.

Median

$116.67

Average

$126.64

Std Dev

$48.10

Max

$239.72

Percentile Distribution (Cost per Claim)

p10
$85.05
p25
$103.62
Median
$116.67
p75
$140.00
p90
$159.94
p95
$199.83
p99
$231.74

50% of providers bill between $103.62 and $140.00 per claim for this code.

90% bill between $85.05 and $159.94.

Top 1% bill above $231.74.

About This Procedure

HCPCS code D5630 was billed by 9 providers across 1,277 claims, totaling $121K in Medicaid payments from 2018–2024. This code was used for 977 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$116.67

Providers Billing

9

National Spending

$121K

Avg/Median Ratio

1.09×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for D5630

#ProviderTotal Paid
11669697561$47K
21407146111$31K
31376932459$15K
41992809420$14K
51437489291$3K
61376689240$3K
71619216405$3K
81720120652$3K
91942717343$1K

Showing top 9 of 9 providers billing this code

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