#1892 of 11K

V5130

HCPCS Procedure Code

HCPCS code V5130 is the #1,892 most-billed Medicaid procedure code, with $12.0M in payments across 9,914 claims from 2018–2024. The national median cost per claim is $1,387.41.

Total Paid

$12.0M

0.00% of all spending

Total Claims

9,914

Providers

Avg Cost/Claim

$1K

National Cost Distribution

How much do providers bill per claim for V5130? Based on 28 providers billing this code nationally.

Median

$1,387.41

Average

$1,135.24

Std Dev

$512.56

Max

$2,571.43

Percentile Distribution (Cost per Claim)

p10

$441.45

p25

$687.86

Median

$1,387.41

p75

$1,460.84

p90

$1,489.30

p95

$1,567.00

p99

$2,309.80

50% of providers bill between $687.86 and $1,460.84 per claim for this code.

90% bill between $441.45 and $1,489.30.

Top 1% bill above $2,309.80.

About This Procedure

HCPCS code V5130 was billed by 28 providers across 9,914 claims, totaling $12.0M in Medicaid payments from 2018–2024. This code was used for 9,666 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$1,387.41

Providers Billing

National Spending

$12.0M

Avg/Median Ratio

0.82×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for V5130

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1760783344	$6.0M	$1,380.89	1.0× median	Below Median
2	1063630614	$1.9M	$1,430.69	1.0× median	Above Median
3	1720270952	$1.1M	$1,448.93	1.0× median	Above Median
4	1710025432	$477K	$1,420.83	1.0× median	Above Median
5	1336352269	$453K	$672.63	0.5× median	Below Median
6	1063630804	$360K	$643.43	0.5× median	Below Median
7	1295873990	$345K	$1,457.37	1.1× median	Above Median
8	1578183547	$334K	$1,445.36	1.0× median	Above Median
9	1710250998	$248K	$1,484.22	1.1× median	Above 75th
10	1225229271	$212K	$413.91	0.3× median	Below Median
11	1205840857	$111K	$948.09	0.7× median	Below Median
12	1538790688	$66K	$1,471.25	1.1× median	Above 75th
13	1508193434	$58K	$1,404.08	1.0× median	Above Median
14	1124622675	$55K	$692.94	0.5× median	Below Median
15	1972528172	$52K	$1,477.23	1.1× median	Above 75th
16	1598891855	$48K	$453.25	0.3× median	Below Median
17	1649333584	$42K	$310.49	0.2× median	Below Median
18	1093884926	$39K	$514.20	0.4× median	Below Median
19	1194886747	$36K	$2,571.43	1.9× median	Top 1%
20	1447232913	$28K	$825.48	0.6× median	Below Median

Showing top 20 of 28 providers billing this code

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