#571 of 11K

V5298

HCPCS Procedure Code

HCPCS code V5298 is the #571 most-billed Medicaid procedure code, with $142.8M in payments across 116K claims from 2018–2024. The national median cost per claim is $1,373.37.

Total Paid

$142.8M

0.01% of all spending

Total Claims

116K

Providers

138

Avg Cost/Claim

$1K

National Cost Distribution

How much do providers bill per claim for V5298? Based on 136 providers billing this code nationally.

Median

$1,373.37

Average

$1,297.99

Std Dev

$312.53

Max

$2,870.33

Percentile Distribution (Cost per Claim)

p10

$887.14

p25

$1,218.15

Median

$1,373.37

p75

$1,434.36

p90

$1,480.32

p95

$1,494.36

p99

$2,286.56

50% of providers bill between $1,218.15 and $1,434.36 per claim for this code.

90% bill between $887.14 and $1,480.32.

Top 1% bill above $2,286.56.

About This Procedure

HCPCS code V5298 was billed by 138 providers across 116K claims, totaling $142.8M in Medicaid payments from 2018–2024. This code was used for 112K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$1,373.37

Providers Billing

136

National Spending

$142.8M

Avg/Median Ratio

0.95×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for V5298

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1760783344	$13.6M	$1,152.14	0.8× median	Below Median
2	1265700942	$12.9M	$1,366.67	1.0× median	Below Median
3	1093091662	$8.8M	$1,412.53	1.0× median	Above Median
4	1043365034	$8.5M	$790.82	0.6× median	Below Median
5	1730277922	$8.1M	$1,443.49	1.1× median	Above 75th
6	1134218332	$6.2M	$922.65	0.7× median	Below Median
7	1144503087	$5.1M	$2,332.73	1.7× median	Top 1%
8	1295882603	$3.8M	$1,273.21	0.9× median	Below Median
9	1922207596	$3.8M	$1,401.60	1.0× median	Above Median
10	1013932557	$3.7M	$1,448.73	1.1× median	Above 75th
11	1346301090	$3.4M	$1,435.28	1.0× median	Above 75th
12	1114063831	$3.3M	$1,886.05	1.4× median	Top 10%
13	1841651411	$2.9M	$1,480.79	1.1× median	Top 10%
14	1497048433	$2.4M	$1,428.70	1.0× median	Above Median
15	1710266440	$2.2M	$1,391.61	1.0× median	Above Median
16	1740324508	$2.0M	$781.62	0.6× median	Below Median
17	1467649152	$2.0M	$1,309.48	1.0× median	Below Median
18	1376623389	$2.0M	$1,397.60	1.0× median	Above Median
19	1588759898	$1.9M	$1,441.37	1.0× median	Above 75th
20	1932137023	$1.9M	$1,008.11	0.7× median	Below Median

Showing top 20 of 138 providers billing this code

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