43274
HCPCS Procedure Code
HCPCS code 43274 is the #4,819 most-billed Medicaid procedure code, with $386K in payments across 2K claims from 2018–2024. The national median cost per claim is $296.21.
Total Paid
$386K
0.00% of all spending
Total Claims
2K
Providers
19
Avg Cost/Claim
$198
National Cost Distribution
How much do providers bill per claim for 43274? Based on 19 providers billing this code nationally.
Median
$296.21
Average
$311.62
Std Dev
$223.11
Max
$1,150.30
Percentile Distribution (Cost per Claim)
50% of providers bill between $193.03 and $341.20 per claim for this code.
90% bill between $161.89 and $383.29.
Top 1% bill above $1,017.12.
About This Procedure
HCPCS code 43274 was billed by 19 providers across 2K claims, totaling $386K in Medicaid payments from 2018–2024. This code was used for 1K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$296.21
Providers Billing
19
National Spending
$386K
Avg/Median Ratio
1.05×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for 43274
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1326091448 | $140K |
| 2 | 1275833915 | $64K |
| 3 | 1417902925 | $50K |
| 4 | 1205909892 | $20K |
| 5 | 1326140153 | $18K |
| 6 | Uofl Health-louisville Inc Louisville, KY · Psychiatric Hospital | $15K |
| 7 | 1437292927 | $14K |
| 8 | 1831218627 | $11K |
| 9 | 1326069824 | $8K |
| 10 | 1437529245 | $7K |
| 11 | 1386682094 | $6K |
| 12 | 1023112117 | $5K |
| 13 | 1629242698 | $5K |
| 14 | 1790082832 | $5K |
| 15 | 1740310689 | $4K |
| 16 | 1760492367 | $4K |
| 17 | Spectrum Health Primary Care Partners Grand Rapids, MI · Psychologist, Clinical Child & Adolescent | $3K |
| 18 | 1104875970 | $3K |
| 19 | 1003267196 | $2K |
Showing top 19 of 19 providers billing this code