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#1862 of 11K

49452

HCPCS Procedure Code

HCPCS code 49452 is the #1,862 most-billed Medicaid procedure code, with $12.6M in payments across 31K claims from 2018–2024. The national median cost per claim is $279.23. Costs vary widely — the 90th percentile is $899.32 per claim, 3.2× the median.

Total Paid

$12.6M

0.00% of all spending

Total Claims

31K

Providers

84

Avg Cost/Claim

$408

National Cost Distribution

How much do providers bill per claim for 49452? Based on 83 providers billing this code nationally.

Median

$279.23

Average

$395.73

Std Dev

$430.52

Max

$2,942.92

Percentile Distribution (Cost per Claim)

p10
$67.41
p25
$86.96
Median
$279.23
p75
$546.50
p90
$899.32
p95
$1,110.33
p99
$1,603.25

50% of providers bill between $86.96 and $546.50 per claim for this code.

90% bill between $67.41 and $899.32.

Top 1% bill above $1,603.25.

About This Procedure

HCPCS code 49452 was billed by 84 providers across 31K claims, totaling $12.6M in Medicaid payments from 2018–2024. This code was used for 28K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$279.23

Providers Billing

83

National Spending

$12.6M

Avg/Median Ratio

1.42×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 49452

#ProviderTotal Paid
1Children's Hospital Corporation

Boston, MA · Clinic/Center

$2.9M
2Scottish Rite Children's Medical Center

Atlanta, GA · Pediatrics Pediatric Hematology-Oncology

$1.5M
3Seattle Children's Hospital

Seattle, WA · Prosthetic/Orthotic Supplier

$1.1M
41669657318$787K
5Spectrum Health Hospitals

Grand Rapids, MI · General Acute Care Hospital

$645K
6Connecticut Children's Medical Center

Hartford, CT · General Acute Care Hospital, Children

$494K
7Children's Hospital

Washington, DC · General Acute Care Hospital Children

$398K
8Childrens Hospital Of Philadelphia

Philadelphia, PA · General Acute Care Hospital Children

$380K
9Nationwide Children's Hospital

Columbus, OH · General Acute Care Hospital

$282K
10Vanderbilt University Medical Center

Nashville, TN · Transplant Surgery

$278K
111215392030$240K
12Arkansas Childrens Hospital

Little Rock, AR · Clinic/Center, Critical Access Hospital

$239K
13Children's Hospital Of Wisconsin, Inc.

Milwaukee, WI · Dentist, Pediatric Dentistry

$228K
14Children's Hospital Medical Center Of Akron

Akron, OH · General Acute Care Hospital Children

$205K
15Phoenix Children's Hospital

Phoenix, AZ · General Acute Care Hospital Children

$184K
161740283324$176K
17Texas Children's Physician Group

Houston, TX · Pediatrics

$174K
181912932997$156K
191528012168$149K
20University Of Wisconsin Hospitals And Clinics Authority

Madison, WI · General Acute Care Hospital

$146K

Showing top 20 of 84 providers billing this code