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#4873 of 11K

78803

HCPCS Procedure Code

HCPCS code 78803 is the #4,873 most-billed Medicaid procedure code, with $367K in payments across 2K claims from 2018–2024. The national median cost per claim is $77.95. Costs vary widely — the 90th percentile is $341.83 per claim, 4.4× the median.

Total Paid

$367K

0.00% of all spending

Total Claims

2K

Providers

17

Avg Cost/Claim

$163

National Cost Distribution

How much do providers bill per claim for 78803? Based on 17 providers billing this code nationally.

Median

$77.95

Average

$161.07

Std Dev

$191.02

Max

$724.99

Percentile Distribution (Cost per Claim)

p10
$25.19
p25
$32.01
Median
$77.95
p75
$216.44
p90
$341.83
p95
$546.03
p99
$689.20

50% of providers bill between $32.01 and $216.44 per claim for this code.

90% bill between $25.19 and $341.83.

Top 1% bill above $689.20.

About This Procedure

HCPCS code 78803 was billed by 17 providers across 2K claims, totaling $367K in Medicaid payments from 2018–2024. This code was used for 2K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$77.95

Providers Billing

17

National Spending

$367K

Avg/Median Ratio

2.07×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for 78803

#ProviderTotal Paid
11972004489$171K
2Boston Medical Center Corporation

Boston, MA · General Acute Care Hospital

$109K
3University Hospital

Newark, NJ · General Acute Care Hospital

$30K
4State Of Mississippi - University Of Mississippi Medical Center

Jackson, MS · General Acute Care Hospital

$17K
5Hartford Hospital

Hartford, CT · General Acute Care Hospital

$9K
61437119310$9K
7Lsu Health Sciences Center Shreveport Faculty Group Practice

Shreveport, LA · Oral & Maxillofacial Surgery

$6K
81265437644$4K
9Temple University Hospital Inc

Philadelphia, PA · General Acute Care Hospital

$2K
101134166945$2K
111740283324$2K
121578682464$2K
131316957913$1K
141780684431$1K
15Texas Children's Physician Group

Houston, TX · Pediatrics

$844
16Medical University Hospital Authority

Charleston, SC · General Acute Care Hospital

$731
171376730358$374

Showing top 17 of 17 providers billing this code