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#7399 of 11K

L5972

HCPCS Procedure Code

HCPCS code L5972 is the #7,399 most-billed Medicaid procedure code, with $19K in payments across 111 claims from 2018–2024. The national median cost per claim is $159.10.

Total Paid

$19K

0.00% of all spending

Total Claims

111

Providers

6

Avg Cost/Claim

$171

National Cost Distribution

How much do providers bill per claim for L5972? Based on 6 providers billing this code nationally.

Median

$159.10

Average

$165.54

Std Dev

$60.74

Max

$263.23

Percentile Distribution (Cost per Claim)

p10
$108.00
p25
$117.55
Median
$159.10
p75
$192.88
p90
$229.52
p95
$246.37
p99
$259.86

50% of providers bill between $117.55 and $192.88 per claim for this code.

90% bill between $108.00 and $229.52.

Top 1% bill above $259.86.

About This Procedure

HCPCS code L5972 was billed by 6 providers across 111 claims, totaling $19K in Medicaid payments from 2018–2024. This code was used for 101 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$159.10

Providers Billing

6

National Spending

$19K

Avg/Median Ratio

1.04×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for L5972

#ProviderTotal Paid
11427179753$8K
21790787018$3K
31164586103$2K
41326048893$2K
51285640979$2K
61437196557$2K

Showing top 6 of 6 providers billing this code

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