43250
HCPCS Procedure Code
HCPCS code 43250 is the #4,397 most-billed Medicaid procedure code, with $615K in payments across 2K claims from 2018–2024. The national median cost per claim is $228.21. Costs vary widely — the 90th percentile is $682.07 per claim, 3.0× the median.
Total Paid
$615K
0.00% of all spending
Total Claims
2K
Providers
13
Avg Cost/Claim
$258
National Cost Distribution
How much do providers bill per claim for 43250? Based on 13 providers billing this code nationally.
Median
$228.21
Average
$296.86
Std Dev
$316.35
Max
$1,015.62
Percentile Distribution (Cost per Claim)
50% of providers bill between $45.72 and $460.11 per claim for this code.
90% bill between $11.54 and $682.07.
Top 1% bill above $976.36.
About This Procedure
HCPCS code 43250 was billed by 13 providers across 2K claims, totaling $615K in Medicaid payments from 2018–2024. This code was used for 2K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$228.21
Providers Billing
13
National Spending
$615K
Avg/Median Ratio
1.30×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for 43250
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1780727636 | $346K |
| 2 | 1558475459 | $147K |
| 3 | 1174063788 | $43K |
| 4 | 1376875518 | $25K |
| 5 | 1205852209 | $16K |
| 6 | 1730120684 | $10K |
| 7 | 1508965401 | $8K |
| 8 | 1104055425 | $6K |
| 9 | 1285727669 | $5K |
| 10 | 1295710317 | $4K |
| 11 | 1316492887 | $3K |
| 12 | 1174955256 | $640 |
| 13 | 1184617938 | $528 |
Showing top 13 of 13 providers billing this code