43245
HCPCS Procedure Code
HCPCS code 43245 is the #6,113 most-billed Medicaid procedure code, with $94K in payments across 1K claims from 2018–2024. The national median cost per claim is $117.84. Costs vary widely — the 90th percentile is $463.44 per claim, 3.9× the median.
Total Paid
$94K
0.00% of all spending
Total Claims
1K
Providers
10
Avg Cost/Claim
$92
National Cost Distribution
How much do providers bill per claim for 43245? Based on 10 providers billing this code nationally.
Median
$117.84
Average
$193.14
Std Dev
$241.08
Max
$770.57
Percentile Distribution (Cost per Claim)
50% of providers bill between $30.18 and $229.78 per claim for this code.
90% bill between $21.73 and $463.44.
Top 1% bill above $739.85.
About This Procedure
HCPCS code 43245 was billed by 10 providers across 1K claims, totaling $94K in Medicaid payments from 2018–2024. This code was used for 614 unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$117.84
Providers Billing
10
National Spending
$94K
Avg/Median Ratio
1.64×
Moderately skewed
Top Providers Billing This Code
Ranked by total Medicaid payments for 43245
| # | Provider | Total Paid |
|---|---|---|
| 1 | Norton Hospitals Inc Louisville, KY · General Acute Care Hospital | $20K |
| 2 | Norton Hospitals, Inc Louisville, KY · General Acute Care Hospital | $20K |
| 3 | 1265489157 | $19K |
| 4 | 1750356788 | $15K |
| 5 | 1104055425 | $7K |
| 6 | 1235183542 | $6K |
| 7 | 1780961300 | $3K |
| 8 | 1285030080 | $2K |
| 9 | 1316492887 | $1K |
| 10 | 1356644066 | $611 |
Showing top 10 of 10 providers billing this code