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#6219 of 11K

Z5816

HCPCS Procedure Code

HCPCS code Z5816 is the #6,219 most-billed Medicaid procedure code, with $83K in payments across 1,274 claims from 2018–2024. The national median cost per claim is $57.78.

Total Paid

$83K

0.00% of all spending

Total Claims

1,274

Providers

2

Avg Cost/Claim

$65

National Cost Distribution

How much do providers bill per claim for Z5816? Based on 2 providers billing this code nationally.

Median

$57.78

Average

$57.78

Std Dev

$13.16

Max

$67.08

Percentile Distribution (Cost per Claim)

p10
$50.33
p25
$53.13
Median
$57.78
p75
$62.43
p90
$65.22
p95
$66.15
p99
$66.89

50% of providers bill between $53.13 and $62.43 per claim for this code.

90% bill between $50.33 and $65.22.

Top 1% bill above $66.89.

About This Procedure

HCPCS code Z5816 was billed by 2 providers across 1,274 claims, totaling $83K in Medicaid payments from 2018–2024. This code was used for 374 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$57.78

Providers Billing

2

National Spending

$83K

Avg/Median Ratio

1.00×

Normal distribution

Provider Coverage

We have 2 providers billing this code in our dataset. Individual provider breakdowns are available for top-spending procedure codes.

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