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#5657 of 11K

43270

HCPCS Procedure Code

HCPCS code 43270 is the #5,657 most-billed Medicaid procedure code, with $159K in payments across 987 claims from 2018–2024. The national median cost per claim is $160.38.

Total Paid

$159K

0.00% of all spending

Total Claims

987

Providers

4

Avg Cost/Claim

$161

National Cost Distribution

How much do providers bill per claim for 43270? Based on 4 providers billing this code nationally.

Median

$160.38

Average

$151.21

Std Dev

$88.44

Max

$248.54

Percentile Distribution (Cost per Claim)

p10
$68.54
p25
$118.09
Median
$160.38
p75
$193.50
p90
$226.53
p95
$237.54
p99
$246.34

50% of providers bill between $118.09 and $193.50 per claim for this code.

90% bill between $68.54 and $226.53.

Top 1% bill above $246.34.

About This Procedure

HCPCS code 43270 was billed by 4 providers across 987 claims, totaling $159K in Medicaid payments from 2018–2024. This code was used for 822 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$160.38

Providers Billing

4

National Spending

$159K

Avg/Median Ratio

0.94×

Normal distribution

Provider Coverage

We have 4 providers billing this code in our dataset. Individual provider breakdowns are available for top-spending procedure codes.