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#1214 of 11K

V5160

HCPCS Procedure Code

HCPCS code V5160 is the #1,214 most-billed Medicaid procedure code, with $33.1M in payments across 109K claims from 2018–2024. The national median cost per claim is $309.52.

Total Paid

$33.1M

0.00% of all spending

Total Claims

109K

Providers

230

Avg Cost/Claim

$304

National Cost Distribution

How much do providers bill per claim for V5160? Based on 226 providers billing this code nationally.

Median

$309.52

Average

$303.59

Std Dev

$137.94

Max

$627.07

Percentile Distribution (Cost per Claim)

p10
$141.77
p25
$202.39
Median
$309.52
p75
$377.71
p90
$500.00
p95
$560.25
p99
$613.48

50% of providers bill between $202.39 and $377.71 per claim for this code.

90% bill between $141.77 and $500.00.

Top 1% bill above $613.48.

About This Procedure

HCPCS code V5160 was billed by 230 providers across 109K claims, totaling $33.1M in Medicaid payments from 2018–2024. This code was used for 102K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$309.52

Providers Billing

226

National Spending

$33.1M

Avg/Median Ratio

0.98×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for V5160

#ProviderTotal Paid
11033585302$5.1M
21164707998$3.5M
31295967552$1.9M
41750621553$1.6M
51336352269$1.2M
61194136424$1.2M
71063630804$840K
81336605757$804K
91124622675$744K
101639101751$724K
111538457957$698K
121093884926$504K
131760661052$484K
141184069288$482K
151710936836$466K
16Umass Memorial Medical Center, Inc.

Worcester, MA · General Acute Care Hospital

$461K
171598891855$444K
181265846166$396K
191538605746$375K
201114081338$330K

Showing top 20 of 230 providers billing this code