Statistical flags indicate unusual patterns — not proof of fraud or wrongdoing. Read our methodology

#6859 of 11K

K0052

HCPCS Procedure Code

HCPCS code K0052 is the #6,859 most-billed Medicaid procedure code, with $39K in payments across 13K claims from 2018–2024. The national median cost per claim is $3.50. Costs vary widely — the 90th percentile is $45.34 per claim, 13.0× the median.

Total Paid

$39K

0.00% of all spending

Total Claims

13K

Providers

37

Avg Cost/Claim

$3

National Cost Distribution

How much do providers bill per claim for K0052? Based on 31 providers billing this code nationally.

Median

$3.50

Average

$16.24

Std Dev

$30.27

Max

$112.72

Percentile Distribution (Cost per Claim)

p10
$0.43
p25
$0.94
Median
$3.50
p75
$9.39
p90
$45.34
p95
$93.41
p99
$106.98

50% of providers bill between $0.94 and $9.39 per claim for this code.

90% bill between $0.43 and $45.34.

Top 1% bill above $106.98.

About This Procedure

HCPCS code K0052 was billed by 37 providers across 13K claims, totaling $39K in Medicaid payments from 2018–2024. This code was used for 12K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$3.50

Providers Billing

31

National Spending

$39K

Avg/Median Ratio

4.64×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for K0052

#ProviderTotal Paid
11114915634$11K
21093716334$9K
3Med Star Surgical & Breathing Equipment Inc.

Bronx, NY · Prosthetic/Orthotic Supplier

$5K
41053400960$4K
51538576509$1K
61396713525$1K
71568464295$1K
81578531356$816
91164426144$615
101639108798$530
111730182023$522
12Palmetto Oxygen Llc

Cary, NC · Durable Medical Equipment & Medical Supplies Oxygen Equipment & Supplies

$485
131407245293$416
141366605677$329
151265523625$311
161497783088$292
171891275590$226
181134120074$221
191790771178$212
20Continuum, Llc

Philadelphia, PA · Durable Medical Equipment & Medical Supplies

$199

Showing top 20 of 37 providers billing this code