D9243
HCPCS Procedure Code
HCPCS code D9243 is the #646 most-billed Medicaid procedure code, with $115.9M in payments across 1.1M claims from 2018–2024. The national median cost per claim is $81.52. Costs vary widely — the 90th percentile is $251.01 per claim, 3.1× the median.
Total Paid
$115.9M
0.01% of all spending
Total Claims
1.1M
Providers
811
Avg Cost/Claim
$105
National Cost Distribution
How much do providers bill per claim for D9243? Based on 801 providers billing this code nationally.
Median
$81.52
Average
$120.30
Std Dev
$110.38
Max
$941.25
Percentile Distribution (Cost per Claim)
50% of providers bill between $54.62 and $147.17 per claim for this code.
90% bill between $35.65 and $251.01.
Top 1% bill above $567.43.
About This Procedure
HCPCS code D9243 was billed by 811 providers across 1.1M claims, totaling $115.9M in Medicaid payments from 2018–2024. This code was used for 652K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$81.52
Providers Billing
801
National Spending
$115.9M
Avg/Median Ratio
1.48×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for D9243
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1528201613 | $9.8M |
| 2 | 1962753608 | $4.1M |
| 3 | 1427237551 | $3.9M |
| 4 | 1124478607 | $2.8M |
| 5 | 1972781375 | $2.5M |
| 6 | 1689779282 | $2.4M |
| 7 | 1376972554 | $2.1M |
| 8 | 1790834083 | $2.1M |
| 9 | 1295186708 | $2.0M |
| 10 | 1235422106 | $1.6M |
| 11 | 1245493386 | $1.6M |
| 12 | Department Of Intellectual And Developmental Disabilities, State Of Tn Nashville, TN · Public Health or Welfare | $1.5M |
| 13 | 1407275183 | $1.5M |
| 14 | 1114093457 | $1.5M |
| 15 | 1265671770 | $1.4M |
| 16 | 1336337526 | $1.2M |
| 17 | 1487012902 | $1.2M |
| 18 | 1255620928 | $1.1M |
| 19 | 1568504538 | $1.1M |
| 20 | 1922587757 | $974K |
Showing top 20 of 811 providers billing this code