V5257
HCPCS Procedure Code
HCPCS code V5257 is the #1,330 most-billed Medicaid procedure code, with $27.1M in payments across 63K claims from 2018–2024. The national median cost per claim is $430.20. Costs vary widely — the 90th percentile is $1,460.87 per claim, 3.4× the median.
Total Paid
$27.1M
0.00% of all spending
Total Claims
63K
Providers
63
Avg Cost/Claim
$431
National Cost Distribution
How much do providers bill per claim for V5257? Based on 60 providers billing this code nationally.
Median
$430.20
Average
$716.54
Std Dev
$729.79
Max
$3,598.63
Percentile Distribution (Cost per Claim)
50% of providers bill between $315.57 and $842.35 per claim for this code.
90% bill between $268.34 and $1,460.87.
Top 1% bill above $3,463.42.
About This Procedure
HCPCS code V5257 was billed by 63 providers across 63K claims, totaling $27.1M in Medicaid payments from 2018–2024. This code was used for 34K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$430.20
Providers Billing
60
National Spending
$27.1M
Avg/Median Ratio
1.67×
Moderately skewed
Top Providers Billing This Code
Ranked by total Medicaid payments for V5257
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1720243637 | $18.4M |
| 2 | 1164707998 | $2.2M |
| 3 | 1144477266 | $823K |
| 4 | 1326117847 | $702K |
| 5 | 1710936836 | $671K |
| 6 | 1245302629 | $556K |
| 7 | 1033527957 | $432K |
| 8 | 1205958691 | $372K |
| 9 | 1609150135 | $345K |
| 10 | 1053309864 | $331K |
| 11 | 1871798710 | $297K |
| 12 | 1467409698 | $252K |
| 13 | 1174715015 | $213K |
| 14 | 1700078094 | $195K |
| 15 | 1417078056 | $162K |
| 16 | 1689023699 | $124K |
| 17 | 1619518214 | $115K |
| 18 | Scottish Rite Children's Medical Center Atlanta, GA · Pediatrics Pediatric Hematology-Oncology | $81K |
| 19 | 1821578618 | $79K |
| 20 | 1417590076 | $78K |
Showing top 20 of 63 providers billing this code