#2646 of 11K

43450

HCPCS Procedure Code

HCPCS code 43450 is the #2,646 most-billed Medicaid procedure code, with $4.4M in payments across 74K claims from 2018–2024. The national median cost per claim is $25.37. Costs vary widely — the 90th percentile is $130.67 per claim, 5.2× the median.

Total Paid

$4.4M

0.00% of all spending

Total Claims

74K

Providers

178

Avg Cost/Claim

$60

National Cost Distribution

How much do providers bill per claim for 43450? Based on 172 providers billing this code nationally.

Median

$25.37

Average

$61.81

Std Dev

$98.24

Max

$1,006.64

Percentile Distribution (Cost per Claim)

p10

$8.43

p25

$16.61

Median

$25.37

p75

$80.94

p90

$130.67

p95

$196.37

p99

$341.38

50% of providers bill between $16.61 and $80.94 per claim for this code.

90% bill between $8.43 and $130.67.

Top 1% bill above $341.38.

About This Procedure

HCPCS code 43450 was billed by 178 providers across 74K claims, totaling $4.4M in Medicaid payments from 2018–2024. This code was used for 65K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$25.37

Providers Billing

172

National Spending

$4.4M

Avg/Median Ratio

2.44×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for 43450

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1235376104	$856K	$100.17	3.9× median	Above 75th
2	Bakersfield Memorial Hospital Bakersfield, CA · General Acute Care Hospital	$509K	$1,006.64	39.7× median	Top 1%
3	1235140385	$327K	$72.55	2.9× median	Above Median
4	1063457380	$246K	$126.66	5.0× median	Above 75th
5	1427388982	$234K	$192.02	7.6× median	Top 10%
6	1952820037	$191K	$114.16	4.5× median	Above 75th
7	1053412189	$163K	$191.96	7.6× median	Top 10%
8	1902849276	$120K	$18.72	0.7× median	Below Median
9	1003981093	$82K	$17.70	0.7× median	Below Median
10	1821141441	$78K	$302.85	11.9× median	Top 10%
11	1861484842	$67K	$37.79	1.5× median	Above Median
12	1740264274	$65K	$63.41	2.5× median	Above Median
13	1639135221	$64K	$272.88	10.8× median	Top 10%
14	1952497117	$60K	$28.24	1.1× median	Above Median
15	1649489469	$57K	$48.09	1.9× median	Above Median
16	1912334533	$53K	$34.05	1.3× median	Above Median
17	1689761546	$52K	$94.18	3.7× median	Above 75th
18	1518950716	$48K	$98.50	3.9× median	Above 75th
19	1053505511	$48K	$92.74	3.7× median	Above 75th
20	1861479545	$43K	$77.16	3.0× median	Above Median

Showing top 20 of 178 providers billing this code

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