42830
HCPCS Procedure Code
HCPCS code 42830 is the #838 most-billed Medicaid procedure code, with $69.0M in payments across 98K claims from 2018–2024. The national median cost per claim is $341.04. Costs vary widely — the 90th percentile is $1,674.13 per claim, 4.9× the median.
Total Paid
$69.0M
0.01% of all spending
Total Claims
98K
Providers
352
Avg Cost/Claim
$707
National Cost Distribution
How much do providers bill per claim for 42830? Based on 350 providers billing this code nationally.
Median
$341.04
Average
$635.66
Std Dev
$704.94
Max
$3,933.96
Percentile Distribution (Cost per Claim)
50% of providers bill between $122.32 and $939.89 per claim for this code.
90% bill between $90.33 and $1,674.13.
Top 1% bill above $2,962.39.
About This Procedure
HCPCS code 42830 was billed by 352 providers across 98K claims, totaling $69.0M in Medicaid payments from 2018–2024. This code was used for 89K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$341.04
Providers Billing
350
National Spending
$69.0M
Avg/Median Ratio
1.86×
Moderately skewed
Top Providers Billing This Code
Ranked by total Medicaid payments for 42830
| # | Provider | Total Paid |
|---|---|---|
| 1 | Connecticut Children's Medical Center Hartford, CT · General Acute Care Hospital, Children | $4.0M |
| 2 | 1689664906 | $3.1M |
| 3 | Childrens Hospital Of The Kings Daughters Inc Norfolk, VA · Social Worker, Clinical | $2.5M |
| 4 | 1316341514 | $2.5M |
| 5 | 1750565594 | $2.4M |
| 6 | State Of Mississippi - University Of Mississippi Medical Center Jackson, MS · General Acute Care Hospital | $2.4M |
| 7 | Children's Hospital Corporation Boston, MA · Clinic/Center | $2.2M |
| 8 | Scottish Rite Children's Medical Center Atlanta, GA · Pediatrics Pediatric Hematology-Oncology | $2.2M |
| 9 | Yale New Haven Hospital New Haven, CT · General Acute Care Hospital | $1.9M |
| 10 | Nationwide Children's Hospital Columbus, OH · General Acute Care Hospital | $1.9M |
| 11 | Children's Hospital Medical Center Of Akron Akron, OH · General Acute Care Hospital Children | $1.7M |
| 12 | Driscoll Childrens Hospital Corpus Christi, TX · Speech-Language Pathologist, | $1.6M |
| 13 | Children's Hospital Medical Center Cincinnati, OH · Clinic/Center, Primary Care | $1.4M |
| 14 | Dayton Children's Hospital Dayton, OH · General Acute Care Hospital, Children | $1.4M |
| 15 | Vhs Childrens Hospital Of Michigan Inc Detroit, MI · Clinic/Center, Ambulatory Surgical | $1.2M |
| 16 | The Nemours Foundation Orlando, FL · General Acute Care Hospital Children | $1.2M |
| 17 | Phoenix Children's Hospital Phoenix, AZ · General Acute Care Hospital Children | $1.2M |
| 18 | Children's Hospital Washington, DC · General Acute Care Hospital Children | $1.0M |
| 19 | 1184900102 | $996K |
| 20 | 1306952726 | $989K |
Showing top 20 of 352 providers billing this code