0459
HCPCS Procedure Code
HCPCS code 0459 is the #6,188 most-billed Medicaid procedure code, with $86K in payments across 5K claims from 2018–2024. The national median cost per claim is $15.11. Costs vary widely — the 90th percentile is $44.16 per claim, 2.9× the median.
Total Paid
$86K
0.00% of all spending
Total Claims
5K
Providers
9
Avg Cost/Claim
$17
National Cost Distribution
How much do providers bill per claim for 0459? Based on 9 providers billing this code nationally.
Median
$15.11
Average
$22.71
Std Dev
$22.80
Max
$71.29
Percentile Distribution (Cost per Claim)
50% of providers bill between $5.16 and $34.47 per claim for this code.
90% bill between $1.15 and $44.16.
Top 1% bill above $68.58.
About This Procedure
HCPCS code 0459 was billed by 9 providers across 5K claims, totaling $86K in Medicaid payments from 2018–2024. This code was used for 4K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$15.11
Providers Billing
9
National Spending
$86K
Avg/Median Ratio
1.50×
Moderately skewed
Top Providers Billing This Code
Ranked by total Medicaid payments for 0459
| # | Provider | Total Paid |
|---|---|---|
| 1 | Dignity Health San Bernardino, CA · General Acute Care Hospital | $36K |
| 2 | 1023000569 | $17K |
| 3 | Seventh-day Adventists Loma Linda University Medical Center Loma Linda, CA · General Acute Care Hospital | $14K |
| 4 | 1730171265 | $11K |
| 5 | University Of California Irvine Orange, CA · General Acute Care Hospital | $5K |
| 6 | 1780676221 | $3K |
| 7 | 1891938122 | $585 |
| 8 | 1275720377 | $317 |
| 9 | County Of Santa Clara San Jose, CA · Case Manager/Care Coordinator | $34 |
Showing top 9 of 9 providers billing this code