43659
HCPCS Procedure Code
HCPCS code 43659 is the #2,295 most-billed Medicaid procedure code, with $7.0M in payments across 2K claims from 2018–2024. The national median cost per claim is $963.93. Costs vary widely — the 90th percentile is $5,151.27 per claim, 5.3× the median.
Total Paid
$7.0M
0.00% of all spending
Total Claims
2K
Providers
9
Avg Cost/Claim
$3K
National Cost Distribution
How much do providers bill per claim for 43659? Based on 9 providers billing this code nationally.
Median
$963.93
Average
$1,782.94
Std Dev
$2,318.18
Max
$6,682.31
Percentile Distribution (Cost per Claim)
50% of providers bill between $368.53 and $1,351.76 per claim for this code.
90% bill between $264.62 and $5,151.27.
Top 1% bill above $6,529.21.
About This Procedure
HCPCS code 43659 was billed by 9 providers across 2K claims, totaling $7.0M in Medicaid payments from 2018–2024. This code was used for 2K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$963.93
Providers Billing
9
National Spending
$7.0M
Avg/Median Ratio
1.85×
Moderately skewed
Top Providers Billing This Code
Ranked by total Medicaid payments for 43659
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1184821373 | $4.5M |
| 2 | 1063588804 | $1.6M |
| 3 | 1356904064 | $494K |
| 4 | 1053672915 | $186K |
| 5 | Uofl Health-louisville Inc Louisville, KY · Psychiatric Hospital | $151K |
| 6 | 1770633109 | $83K |
| 7 | Holyoke Medical Center, Inc. Holyoke, MA · Clinic/Center, Adult Mental Health | $8K |
| 8 | 1508101460 | $8K |
| 9 | 1952540395 | $6K |
Showing top 9 of 9 providers billing this code