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#3296 of 11K

V5255

HCPCS Procedure Code

HCPCS code V5255 is the #3,296 most-billed Medicaid procedure code, with $2.0M in payments across 4,807 claims from 2018–2024. The national median cost per claim is $397.07. Costs vary widely — the 90th percentile is $820.70 per claim, 2.1× the median.

Total Paid

$2.0M

0.00% of all spending

Total Claims

4,807

Providers

3

Avg Cost/Claim

$413

National Cost Distribution

How much do providers bill per claim for V5255? Based on 3 providers billing this code nationally.

Median

$397.07

Average

$559.73

Std Dev

$318.41

Max

$926.61

Percentile Distribution (Cost per Claim)

p10
$363.81
p25
$376.28
Median
$397.07
p75
$661.84
p90
$820.70
p95
$873.66
p99
$916.02

50% of providers bill between $376.28 and $661.84 per claim for this code.

90% bill between $363.81 and $820.70.

Top 1% bill above $916.02.

About This Procedure

HCPCS code V5255 was billed by 3 providers across 4,807 claims, totaling $2.0M in Medicaid payments from 2018–2024. This code was used for 2,073 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$397.07

Providers Billing

3

National Spending

$2.0M

Avg/Median Ratio

1.41×

Normal distribution

Provider Coverage

We have 3 providers billing this code in our dataset. Individual provider breakdowns are available for top-spending procedure codes.