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#6745 of 11K

46255

HCPCS Procedure Code

HCPCS code 46255 is the #6,745 most-billed Medicaid procedure code, with $45K in payments across 71 claims from 2018–2024. The national median cost per claim is $368.03. Costs vary widely — the 90th percentile is $1,039.62 per claim, 2.8× the median.

Total Paid

$45K

0.00% of all spending

Total Claims

71

Providers

3

Avg Cost/Claim

$633

National Cost Distribution

How much do providers bill per claim for 46255? Based on 3 providers billing this code nationally.

Median

$368.03

Average

$641.29

Std Dev

$490.48

Max

$1,207.52

Percentile Distribution (Cost per Claim)

p10
$352.25
p25
$358.17
Median
$368.03
p75
$787.77
p90
$1,039.62
p95
$1,123.57
p99
$1,190.73

50% of providers bill between $358.17 and $787.77 per claim for this code.

90% bill between $352.25 and $1,039.62.

Top 1% bill above $1,190.73.

About This Procedure

HCPCS code 46255 was billed by 3 providers across 71 claims, totaling $45K in Medicaid payments from 2018–2024. This code was used for 50 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$368.03

Providers Billing

3

National Spending

$45K

Avg/Median Ratio

1.74×

Moderately skewed

Provider Coverage

We have 3 providers billing this code in our dataset. Individual provider breakdowns are available for top-spending procedure codes.

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