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#2636 of 11K

V5265

HCPCS Procedure Code

HCPCS code V5265 is the #2,636 most-billed Medicaid procedure code, with $4.4M in payments across 71K claims from 2018–2024. The national median cost per claim is $43.02.

Total Paid

$4.4M

0.00% of all spending

Total Claims

71K

Providers

26

Avg Cost/Claim

$62

National Cost Distribution

How much do providers bill per claim for V5265? Based on 24 providers billing this code nationally.

Median

$43.02

Average

$51.70

Std Dev

$34.21

Max

$167.80

Percentile Distribution (Cost per Claim)

p10
$21.09
p25
$34.05
Median
$43.02
p75
$69.69
p90
$85.59
p95
$94.08
p99
$151.13

50% of providers bill between $34.05 and $69.69 per claim for this code.

90% bill between $21.09 and $85.59.

Top 1% bill above $151.13.

About This Procedure

HCPCS code V5265 was billed by 26 providers across 71K claims, totaling $4.4M in Medicaid payments from 2018–2024. This code was used for 44K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$43.02

Providers Billing

24

National Spending

$4.4M

Avg/Median Ratio

1.20×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for V5265

#ProviderTotal Paid
11659681823$3.6M
21538457957$539K
31134218332$71K
41689023699$51K
51194886747$34K
61922350297$34K
71871798710$32K
81619252244$32K
91164707998$29K
101053309864$17K
111053765388$8K
121013991017$8K
131356860811$5K
141780805697$3K
151104944594$3K
161013173731$3K
171285776005$2K
181306054234$2K
191336354794$2K
201033585302$741

Showing top 20 of 26 providers billing this code