W5996
HCPCS Procedure Code
HCPCS code W5996 is the #2,668 most-billed Medicaid procedure code, with $4.3M in payments across 16K claims from 2018–2024. The national median cost per claim is $206.25.
Total Paid
$4.3M
0.00% of all spending
Total Claims
16K
Providers
6
Avg Cost/Claim
$261
National Cost Distribution
How much do providers bill per claim for W5996? Based on 6 providers billing this code nationally.
Median
$206.25
Average
$187.79
Std Dev
$75.36
Max
$278.82
Percentile Distribution (Cost per Claim)
50% of providers bill between $167.32 and $219.90 per claim for this code.
90% bill between $106.93 and $250.20.
Top 1% bill above $275.96.
About This Procedure
HCPCS code W5996 was billed by 6 providers across 16K claims, totaling $4.3M in Medicaid payments from 2018–2024. This code was used for 1,920 unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$206.25
Providers Billing
6
National Spending
$4.3M
Avg/Median Ratio
0.91×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for W5996
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1982804290 | $3.8M |
| 2 | Hope Enterprises Inc. Williamsport, PA · Voluntary or Charitable | $336K |
| 3 | 1679627863 | $42K |
| 4 | Maxim Healthcare Services Inc. Allentown, PA · Home Health | $42K |
| 5 | Wesley Family Services Wilkinsburg, PA · Clinic/Center Mental Health (Including Community Mental Health Center) | $28K |
| 6 | 1588782148 | $23K |
Showing top 6 of 6 providers billing this code