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#2242 of 11K

43762

HCPCS Procedure Code

HCPCS code 43762 is the #2,242 most-billed Medicaid procedure code, with $7.5M in payments across 62K claims from 2018–2024. The national median cost per claim is $99.73. Costs vary widely — the 90th percentile is $225.44 per claim, 2.3× the median.

Total Paid

$7.5M

0.00% of all spending

Total Claims

62K

Providers

161

Avg Cost/Claim

$122

National Cost Distribution

How much do providers bill per claim for 43762? Based on 159 providers billing this code nationally.

Median

$99.73

Average

$112.00

Std Dev

$89.02

Max

$406.78

Percentile Distribution (Cost per Claim)

p10
$18.36
p25
$27.39
Median
$99.73
p75
$168.59
p90
$225.44
p95
$279.63
p99
$343.20

50% of providers bill between $27.39 and $168.59 per claim for this code.

90% bill between $18.36 and $225.44.

Top 1% bill above $343.20.

About This Procedure

HCPCS code 43762 was billed by 161 providers across 62K claims, totaling $7.5M in Medicaid payments from 2018–2024. This code was used for 56K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$99.73

Providers Billing

159

National Spending

$7.5M

Avg/Median Ratio

1.12×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 43762

#ProviderTotal Paid
1Phoenix Children's Hospital

Phoenix, AZ · General Acute Care Hospital Children

$694K
21790880292$592K
3Rector & Visitors Of The University Of Virginia

Charlottesville, VA · General Acute Care Hospital

$363K
4State Of Mississippi - University Of Mississippi Medical Center

Jackson, MS · General Acute Care Hospital

$341K
51568928588$246K
6Virginia Commonwealth University Health System Authority

Richmond, VA · General Acute Care Hospital

$217K
71336533041$205K
8Childrens Hospital Of The Kings Daughters Inc

Norfolk, VA · Social Worker, Clinical

$204K
9Regents Of The University Of Michigan

Ann Arbor, MI · Clinic/Center, End-Stage Renal Disease (ESRD) Treatment

$204K
10Yale New Haven Hospital

New Haven, CT · General Acute Care Hospital

$188K
11Seattle Children's Hospital

Seattle, WA · Prosthetic/Orthotic Supplier

$186K
12Children's Hospital Of Wisconsin, Inc.

Milwaukee, WI · Dentist, Pediatric Dentistry

$166K
131265530653$163K
141124203872$159K
151174582282$156K
16Vanderbilt University Medical Center

Nashville, TN · Transplant Surgery

$152K
17Children's Hospital Medical Center

Cincinnati, OH · Clinic/Center, Primary Care

$151K
181487868097$141K
191306952726$132K
201093090342$131K

Showing top 20 of 161 providers billing this code