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#2214 of 11K

V5256

HCPCS Procedure Code

HCPCS code V5256 is the #2,214 most-billed Medicaid procedure code, with $7.8M in payments across 18K claims from 2018–2024. The national median cost per claim is $360.78. Costs vary widely — the 90th percentile is $1,234.02 per claim, 3.4× the median.

Total Paid

$7.8M

0.00% of all spending

Total Claims

18K

Providers

26

Avg Cost/Claim

$435

National Cost Distribution

How much do providers bill per claim for V5256? Based on 25 providers billing this code nationally.

Median

$360.78

Average

$582.69

Std Dev

$411.20

Max

$1,630.68

Percentile Distribution (Cost per Claim)

p10
$290.85
p25
$309.58
Median
$360.78
p75
$747.41
p90
$1,234.02
p95
$1,245.05
p99
$1,538.55

50% of providers bill between $309.58 and $747.41 per claim for this code.

90% bill between $290.85 and $1,234.02.

Top 1% bill above $1,538.55.

About This Procedure

HCPCS code V5256 was billed by 26 providers across 18K claims, totaling $7.8M in Medicaid payments from 2018–2024. This code was used for 11K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$360.78

Providers Billing

25

National Spending

$7.8M

Avg/Median Ratio

1.62×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for V5256

#ProviderTotal Paid
11205466166$2.9M
21720243637$1.2M
31821119314$775K
41619518214$674K
51225398837$500K
61164707998$397K
71528557402$312K
81225355860$191K
91467409698$190K
101093466088$119K
111245302629$108K
121205958691$102K
131811312515$95K
141962448233$70K
151710936836$43K
161316471659$37K
171184950768$33K
181447283882$8K
191427514710$7K
201093056004$5K

Showing top 20 of 26 providers billing this code