V5259
HCPCS Procedure Code
HCPCS code V5259 is the #4,907 most-billed Medicaid procedure code, with $358K in payments across 163 claims from 2018–2024. The national median cost per claim is $790.31. Costs vary widely — the 90th percentile is $2,675.69 per claim, 3.4× the median.
Total Paid
$358K
0.00% of all spending
Total Claims
163
Providers
4
Avg Cost/Claim
$2K
National Cost Distribution
How much do providers bill per claim for V5259? Based on 4 providers billing this code nationally.
Median
$790.31
Average
$1,416.15
Std Dev
$1,364.30
Max
$3,457.97
Percentile Distribution (Cost per Claim)
50% of providers bill between $704.20 and $1,502.27 per claim for this code.
90% bill between $657.28 and $2,675.69.
Top 1% bill above $3,379.74.
About This Procedure
HCPCS code V5259 was billed by 4 providers across 163 claims, totaling $358K in Medicaid payments from 2018–2024. This code was used for 155 unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$790.31
Providers Billing
4
National Spending
$358K
Avg/Median Ratio
1.79×
Moderately skewed
Provider Coverage
We have 4 providers billing this code in our dataset. Individual provider breakdowns are available for top-spending procedure codes.