42700
HCPCS Procedure Code
HCPCS code 42700 is the #3,966 most-billed Medicaid procedure code, with $974K in payments across 3,255 claims from 2018–2024. The national median cost per claim is $361.34.
Total Paid
$974K
0.00% of all spending
Total Claims
3,255
Providers
12
Avg Cost/Claim
$299
National Cost Distribution
How much do providers bill per claim for 42700? Based on 12 providers billing this code nationally.
Median
$361.34
Average
$312.33
Std Dev
$134.30
Max
$427.00
Percentile Distribution (Cost per Claim)
50% of providers bill between $217.25 and $411.67 per claim for this code.
90% bill between $141.73 and $427.00.
Top 1% bill above $427.00.
About This Procedure
HCPCS code 42700 was billed by 12 providers across 3,255 claims, totaling $974K in Medicaid payments from 2018–2024. This code was used for 2,626 unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$361.34
Providers Billing
12
National Spending
$974K
Avg/Median Ratio
0.86×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for 42700
| # | Provider | Total Paid |
|---|---|---|
| 1 | Rosebud Indian Health Service Rosebud, SD · General Acute Care Hospital | $383K |
| 2 | 1609851039 | $263K |
| 3 | The Fort Defiance Indian Hospital Board, Incorporation Fort Defiance, AZ · General Acute Care Hospital | $195K |
| 4 | 1760427587 | $44K |
| 5 | 1710995907 | $24K |
| 6 | 1336286798 | $23K |
| 7 | 1265511299 | $12K |
| 8 | Dhhs,phs,naihs, Gallup Indian Medical Center Gallup, NM · General Acute Care Hospital | $11K |
| 9 | 1437188729 | $7K |
| 10 | Kewa Pueblo Health Corporation Santo Domingo Pueblo, NM · Clinic/Center | $7K |
| 11 | 1114472891 | $6K |
| 12 | 1225182801 | $511 |
Showing top 12 of 12 providers billing this code