59425
Antepartum care only, 4-6 visits
Antepartum care only, 4-6 visits is the #424 most-billed Medicaid procedure code, with $243.8M in payments across 3.9M claims from 2018–2024. The national median cost per claim is $63.63. Costs vary widely — the 90th percentile is $303.41 per claim, 4.8× the median.
Total Paid
$243.8M
0.02% of all spending
Total Claims
3.9M
Providers
2K
Avg Cost/Claim
$62
National Cost Distribution
How much do providers bill per claim for 59425? Based on 2K providers billing this code nationally.
Median
$63.63
Average
$100.36
Std Dev
$125.60
Max
$1,003.48
Percentile Distribution (Cost per Claim)
50% of providers bill between $46.39 and $85.48 per claim for this code.
90% bill between $12.05 and $303.41.
Top 1% bill above $541.68.
About This Procedure
HCPCS code 59425 (Antepartum care only, 4-6 visits) was billed by 2K providers across 3.9M claims, totaling $243.8M in Medicaid payments from 2018–2024. This code was used for 2.7M unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$63.63
Providers Billing
2K
National Spending
$243.8M
Avg/Median Ratio
1.58×
Moderately skewed
Top Providers Billing This Code
Ranked by total Medicaid payments for 59425
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1851821565 | $5.6M |
| 2 | 1245234673 | $4.2M |
| 3 | 1376949503 | $3.8M |
| 4 | Community Physicians Of Indiana Inc Indianapolis, IN · Internal Medicine | $3.5M |
| 5 | 1851643241 | $2.7M |
| 6 | 1679642326 | $2.4M |
| 7 | 1730169756 | $2.3M |
| 8 | 1427176569 | $2.2M |
| 9 | 1720190002 | $2.2M |
| 10 | 1891937827 | $2.2M |
| 11 | 1225327984 | $2.2M |
| 12 | 1669470019 | $2.2M |
| 13 | 1780634964 | $2.1M |
| 14 | 1083868269 | $2.0M |
| 15 | 1306898960 | $2.0M |
| 16 | 1760545503 | $2.0M |
| 17 | 1730258765 | $1.9M |
| 18 | 1215903018 | $1.9M |
| 19 | 1104008887 | $1.8M |
| 20 | 1144304817 | $1.7M |
Showing top 20 of 2K providers billing this code