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#4694 of 11K

K0455

HCPCS Procedure Code

HCPCS code K0455 is the #4,694 most-billed Medicaid procedure code, with $446K in payments across 12K claims from 2018–2024. The national median cost per claim is $27.80.

Total Paid

$446K

0.00% of all spending

Total Claims

12K

Providers

10

Avg Cost/Claim

$38

National Cost Distribution

How much do providers bill per claim for K0455? Based on 10 providers billing this code nationally.

Median

$27.80

Average

$34.06

Std Dev

$22.31

Max

$83.08

Percentile Distribution (Cost per Claim)

p10
$12.69
p25
$23.03
Median
$27.80
p75
$44.81
p90
$55.38
p95
$69.23
p99
$80.31

50% of providers bill between $23.03 and $44.81 per claim for this code.

90% bill between $12.69 and $55.38.

Top 1% bill above $80.31.

About This Procedure

HCPCS code K0455 was billed by 10 providers across 12K claims, totaling $446K in Medicaid payments from 2018–2024. This code was used for 10K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$27.80

Providers Billing

10

National Spending

$446K

Avg/Median Ratio

1.23×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for K0455

#ProviderTotal Paid
1Accredo Health Group Inc

Warrendale, PA · Pharmacy, Community/Retail Pharmacy

$249K
21952359150$125K
31013998921$16K
41134100134$14K
5Accredo Health Group Inc

Orlando, FL · Pharmacy Specialty Pharmacy

$13K
61821043027$11K
7Procare Pharmacy Direct, Llc.

Monroeville, PA · Pharmacy, Community/Retail Pharmacy

$10K
81629232756$8K
91710933007$732
101407807191$423

Showing top 10 of 10 providers billing this code

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