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#2158 of 11K

43248

HCPCS Procedure Code

HCPCS code 43248 is the #2,158 most-billed Medicaid procedure code, with $8.4M in payments across 60K claims from 2018–2024. The national median cost per claim is $115.74. Costs vary widely — the 90th percentile is $366.09 per claim, 3.2× the median.

Total Paid

$8.4M

0.00% of all spending

Total Claims

60K

Providers

197

Avg Cost/Claim

$140

National Cost Distribution

How much do providers bill per claim for 43248? Based on 195 providers billing this code nationally.

Median

$115.74

Average

$170.91

Std Dev

$143.30

Max

$844.53

Percentile Distribution (Cost per Claim)

p10
$52.10
p25
$74.16
Median
$115.74
p75
$225.13
p90
$366.09
p95
$470.26
p99
$609.48

50% of providers bill between $74.16 and $225.13 per claim for this code.

90% bill between $52.10 and $366.09.

Top 1% bill above $609.48.

About This Procedure

HCPCS code 43248 was billed by 197 providers across 60K claims, totaling $8.4M in Medicaid payments from 2018–2024. This code was used for 49K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$115.74

Providers Billing

195

National Spending

$8.4M

Avg/Median Ratio

1.48×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 43248

#ProviderTotal Paid
11780727636$688K
21568638047$439K
3Yuma Regional Medical Center

Yuma, AZ · General Acute Care Hospital

$436K
41093713091$383K
51740277821$349K
61093781601$323K
71538242649$272K
81649376112$239K
91558475459$230K
101659368900$209K
111447231956$206K
121891740585$181K
131114912102$179K
141245352327$178K
151093736795$176K
161356528269$150K
171487651956$139K
181407805971$136K
191831349406$133K
201598042343$132K

Showing top 20 of 197 providers billing this code