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#6876 of 11K

K0056

HCPCS Procedure Code

HCPCS code K0056 is the #6,876 most-billed Medicaid procedure code, with $38K in payments across 1,261 claims from 2018–2024. The national median cost per claim is $14.97. Costs vary widely — the 90th percentile is $53.00 per claim, 3.5× the median.

Total Paid

$38K

0.00% of all spending

Total Claims

1,261

Providers

8

Avg Cost/Claim

$30

National Cost Distribution

How much do providers bill per claim for K0056? Based on 8 providers billing this code nationally.

Median

$14.97

Average

$24.15

Std Dev

$20.21

Max

$58.98

Percentile Distribution (Cost per Claim)

p10
$7.14
p25
$11.51
Median
$14.97
p75
$33.84
p90
$53.00
p95
$55.99
p99
$58.39

50% of providers bill between $11.51 and $33.84 per claim for this code.

90% bill between $7.14 and $53.00.

Top 1% bill above $58.39.

About This Procedure

HCPCS code K0056 was billed by 8 providers across 1,261 claims, totaling $38K in Medicaid payments from 2018–2024. This code was used for 964 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$14.97

Providers Billing

8

National Spending

$38K

Avg/Median Ratio

1.61×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for K0056

#ProviderTotal Paid
11639296817$27K
21730182023$6K
31447429642$2K
4Med Star Surgical & Breathing Equipment Inc.

Bronx, NY · Prosthetic/Orthotic Supplier

$1K
51457314130$771
61427153626$570
71659361947$453
81134303902$62

Showing top 8 of 8 providers billing this code