43252
HCPCS Procedure Code
HCPCS code 43252 is the #5,909 most-billed Medicaid procedure code, with $120K in payments across 722 claims from 2018–2024. The national median cost per claim is $64.45. Costs vary widely — the 90th percentile is $529.01 per claim, 8.2× the median.
Total Paid
$120K
0.00% of all spending
Total Claims
722
Providers
11
Avg Cost/Claim
$167
National Cost Distribution
How much do providers bill per claim for 43252? Based on 11 providers billing this code nationally.
Median
$64.45
Average
$223.64
Std Dev
$338.63
Max
$1,112.33
Percentile Distribution (Cost per Claim)
50% of providers bill between $26.62 and $284.68 per claim for this code.
90% bill between $1.12 and $529.01.
Top 1% bill above $1,054.00.
About This Procedure
HCPCS code 43252 was billed by 11 providers across 722 claims, totaling $120K in Medicaid payments from 2018–2024. This code was used for 666 unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$64.45
Providers Billing
11
National Spending
$120K
Avg/Median Ratio
3.47×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for 43252
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1558753095 | $71K |
| 2 | 1093395501 | $16K |
| 3 | 1134297492 | $13K |
| 4 | 1396812491 | $7K |
| 5 | 1952820037 | $4K |
| 6 | 1700816733 | $4K |
| 7 | 1598190134 | $3K |
| 8 | 1467961078 | $1K |
| 9 | 1932216389 | $1K |
| 10 | 1902980675 | $15 |
| 11 | 1134228224 | $11 |
Showing top 11 of 11 providers billing this code