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#3238 of 11K

V5020

HCPCS Procedure Code

HCPCS code V5020 is the #3,238 most-billed Medicaid procedure code, with $2.2M in payments across 52K claims from 2018–2024. The national median cost per claim is $34.66. Costs vary widely — the 90th percentile is $88.19 per claim, 2.5× the median.

Total Paid

$2.2M

0.00% of all spending

Total Claims

52K

Providers

77

Avg Cost/Claim

$42

National Cost Distribution

How much do providers bill per claim for V5020? Based on 72 providers billing this code nationally.

Median

$34.66

Average

$49.34

Std Dev

$51.46

Max

$327.69

Percentile Distribution (Cost per Claim)

p10
$16.71
p25
$22.52
Median
$34.66
p75
$60.62
p90
$88.19
p95
$90.55
p99
$306.30

50% of providers bill between $22.52 and $60.62 per claim for this code.

90% bill between $16.71 and $88.19.

Top 1% bill above $306.30.

About This Procedure

HCPCS code V5020 was billed by 77 providers across 52K claims, totaling $2.2M in Medicaid payments from 2018–2024. This code was used for 43K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$34.66

Providers Billing

72

National Spending

$2.2M

Avg/Median Ratio

1.42×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for V5020

#ProviderTotal Paid
11891745758$242K
21194886747$200K
31538457957$187K
4Children's Hospital Of Wisconsin, Inc.

Milwaukee, WI · Dentist, Pediatric Dentistry

$187K
51063454346$125K
61962400036$94K
71245251222$89K
81033585302$85K
91639101751$73K
101720151145$67K
111952746265$67K
121013352046$66K
131053820332$61K
141023365012$57K
15Long Island Jewish Medical Center

New Hyde Park, NY · General Acute Care Hospital

$54K
16Medstar Washington Hospital Center

Washington, DC · General Acute Care Hospital

$52K
171669872453$50K
181932248333$37K
19Group Health Plan, Inc.

Minneapolis, MN · Clinic/Center, Multi-Specialty

$32K
201588953640$27K

Showing top 20 of 77 providers billing this code