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#7564 of 11K

42800

HCPCS Procedure Code

HCPCS code 42800 is the #7,564 most-billed Medicaid procedure code, with $15K in payments across 146 claims from 2018–2024. The national median cost per claim is $99.59.

Total Paid

$15K

0.00% of all spending

Total Claims

146

Providers

1

Avg Cost/Claim

$100

National Cost Distribution

How much do providers bill per claim for 42800? Based on 1 providers billing this code nationally.

Median

$99.59

Average

$99.59

Std Dev

Max

$99.59

Percentile Distribution (Cost per Claim)

p10
$99.59
p25
$99.59
Median
$99.59
p75
$99.59
p90
$99.59
p95
$99.59
p99
$99.59

50% of providers bill between $99.59 and $99.59 per claim for this code.

90% bill between $99.59 and $99.59.

Top 1% bill above $99.59.

About This Procedure

HCPCS code 42800 was billed by 1 providers across 146 claims, totaling $15K in Medicaid payments from 2018–2024. This code was used for 137 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$99.59

Providers Billing

1

National Spending

$15K

Avg/Median Ratio

1.00×

Normal distribution

Provider Coverage

We have 1 providers billing this code in our dataset. Individual provider breakdowns are available for top-spending procedure codes.