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#781 of 11K

59430

HCPCS Procedure Code

HCPCS code 59430 is the #781 most-billed Medicaid procedure code, with $81.7M in payments across 974K claims from 2018–2024. The national median cost per claim is $80.32. Costs vary widely — the 90th percentile is $184.05 per claim, 2.3× the median.

Total Paid

$81.7M

0.01% of all spending

Total Claims

974K

Providers

2K

Avg Cost/Claim

$84

National Cost Distribution

How much do providers bill per claim for 59430? Based on 2K providers billing this code nationally.

Median

$80.32

Average

$91.13

Std Dev

$62.28

Max

$440.10

Percentile Distribution (Cost per Claim)

p10
$18.54
p25
$50.15
Median
$80.32
p75
$119.68
p90
$184.05
p95
$215.95
p99
$270.21

50% of providers bill between $50.15 and $119.68 per claim for this code.

90% bill between $18.54 and $184.05.

Top 1% bill above $270.21.

About This Procedure

HCPCS code 59430 was billed by 2K providers across 974K claims, totaling $81.7M in Medicaid payments from 2018–2024. This code was used for 867K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$80.32

Providers Billing

2K

National Spending

$81.7M

Avg/Median Ratio

1.13×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 59430

#ProviderTotal Paid
11235177924$3.7M
21386823243$1.1M
31669422234$928K
41093145377$732K
5Lsu Health Sciences Center Shreveport Faculty Group Practice

Shreveport, LA · Oral & Maxillofacial Surgery

$718K
61891803904$689K
71417961137$638K
8William Beaumont Hospital

Royal Oak, MI · Internal Medicine, Cardiovascular Disease

$638K
91114025749$631K
101013902923$625K
11Utmb Faculty Group Practice

Galveston, TX · Anesthesiology

$607K
121790856235$603K
13Spectrum Health Primary Care Partners

Grand Rapids, MI · Psychologist, Clinical Child & Adolescent

$603K
141073827101$585K
151992040166$575K
16University Of Texas Medical Branch At Galveston

Galveston, TX · Clinic/Center, Ambulatory Surgical

$570K
171639104854$510K
181922210517$504K
191528113032$481K
201063659134$455K

Showing top 20 of 2K providers billing this code