54163
HCPCS Procedure Code
HCPCS code 54163 is the #3,780 most-billed Medicaid procedure code, with $1.2M in payments across 2K claims from 2018–2024. The national median cost per claim is $414.20. Costs vary widely — the 90th percentile is $1,377.52 per claim, 3.3× the median.
Total Paid
$1.2M
0.00% of all spending
Total Claims
2K
Providers
23
Avg Cost/Claim
$660
National Cost Distribution
How much do providers bill per claim for 54163? Based on 22 providers billing this code nationally.
Median
$414.20
Average
$640.20
Std Dev
$559.88
Max
$1,888.47
Percentile Distribution (Cost per Claim)
50% of providers bill between $166.13 and $978.91 per claim for this code.
90% bill between $114.85 and $1,377.52.
Top 1% bill above $1,816.12.
About This Procedure
HCPCS code 54163 was billed by 23 providers across 2K claims, totaling $1.2M in Medicaid payments from 2018–2024. This code was used for 2K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$414.20
Providers Billing
22
National Spending
$1.2M
Avg/Median Ratio
1.55×
Moderately skewed
Top Providers Billing This Code
Ranked by total Medicaid payments for 54163
| # | Provider | Total Paid |
|---|---|---|
| 1 | Children's Hospital Medical Center Cincinnati, OH · Clinic/Center, Primary Care | $426K |
| 2 | Norton Hospitals Inc Louisville, KY · General Acute Care Hospital | $193K |
| 3 | Vhs Childrens Hospital Of Michigan Inc Detroit, MI · Clinic/Center, Ambulatory Surgical | $144K |
| 4 | Scottish Rite Children's Medical Center Atlanta, GA · Pediatrics Pediatric Hematology-Oncology | $80K |
| 5 | Norton Hospitals, Inc Louisville, KY · General Acute Care Hospital | $70K |
| 6 | University Of Kentucky Lexington, KY · General Acute Care Hospital | $60K |
| 7 | Children's Hospital Medical Center Of Akron Akron, OH · General Acute Care Hospital Children | $48K |
| 8 | 1275988321 | $34K |
| 9 | Children's Hospital Corporation Boston, MA · Clinic/Center | $23K |
| 10 | Suny Health Science Center At Syracuse Syracuse, NY · General Acute Care Hospital | $20K |
| 11 | Yale New Haven Hospital New Haven, CT · General Acute Care Hospital | $19K |
| 12 | 1699874248 | $16K |
| 13 | 1073827101 | $13K |
| 14 | Arkansas Childrens Hospital Little Rock, AR · Clinic/Center, Critical Access Hospital | $10K |
| 15 | 1609915784 | $7K |
| 16 | 1104877141 | $4K |
| 17 | 1396274841 | $3K |
| 18 | Florida Clinical Practice Association Inc Gainesville, FL · Surgery | $3K |
| 19 | 1093024101 | $2K |
| 20 | 1952357493 | $2K |
Showing top 20 of 23 providers billing this code