43264
HCPCS Procedure Code
HCPCS code 43264 is the #2,959 most-billed Medicaid procedure code, with $2.9M in payments across 9K claims from 2018–2024. The national median cost per claim is $213.91. Costs vary widely — the 90th percentile is $648.51 per claim, 3.0× the median.
Total Paid
$2.9M
0.00% of all spending
Total Claims
9K
Providers
75
Avg Cost/Claim
$313
National Cost Distribution
How much do providers bill per claim for 43264? Based on 70 providers billing this code nationally.
Median
$213.91
Average
$311.78
Std Dev
$271.71
Max
$1,366.40
Percentile Distribution (Cost per Claim)
50% of providers bill between $144.92 and $371.06 per claim for this code.
90% bill between $101.50 and $648.51.
Top 1% bill above $1,210.96.
About This Procedure
HCPCS code 43264 was billed by 75 providers across 9K claims, totaling $2.9M in Medicaid payments from 2018–2024. This code was used for 8K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$213.91
Providers Billing
70
National Spending
$2.9M
Avg/Median Ratio
1.46×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for 43264
| # | Provider | Total Paid |
|---|---|---|
| 1 | University Of Kentucky Lexington, KY · General Acute Care Hospital | $795K |
| 2 | 1326091448 | $311K |
| 3 | Rector & Visitors Of The University Of Virginia Charlottesville, VA · General Acute Care Hospital | $197K |
| 4 | Unm Hospital Albuquerque, NM · General Acute Care Hospital | $194K |
| 5 | 1023112117 | $173K |
| 6 | 1831218627 | $128K |
| 7 | Regents Of The University Of Michigan Ann Arbor, MI · Clinic/Center, End-Stage Renal Disease (ESRD) Treatment | $117K |
| 8 | Ohio State University Hospitals Columbus, OH · General Acute Care Hospital | $73K |
| 9 | 1326069824 | $67K |
| 10 | 1205909892 | $66K |
| 11 | Umass Memorial Medical Center, Inc. Worcester, MA · General Acute Care Hospital | $63K |
| 12 | 1326140153 | $53K |
| 13 | 1801827639 | $51K |
| 14 | 1801226162 | $50K |
| 15 | Henry Ford Health System Detroit, MI · General Acute Care Hospital | $46K |
| 16 | 1932112125 | $43K |
| 17 | West Virginia University Medical Corporation Morgantown, WV · Anesthesiology | $39K |
| 18 | 1790082832 | $30K |
| 19 | Aurora Health Care Metro, Inc. Milwaukee, WI · Internal Medicine, Hematology & Oncology | $27K |
| 20 | Yale New Haven Hospital New Haven, CT · General Acute Care Hospital | $25K |
Showing top 20 of 75 providers billing this code