49465
HCPCS Procedure Code
HCPCS code 49465 is the #4,778 most-billed Medicaid procedure code, with $408K in payments across 3K claims from 2018–2024. The national median cost per claim is $25.16. Costs vary widely — the 90th percentile is $171.99 per claim, 6.8× the median.
Total Paid
$408K
0.00% of all spending
Total Claims
3K
Providers
19
Avg Cost/Claim
$127
National Cost Distribution
How much do providers bill per claim for 49465? Based on 17 providers billing this code nationally.
Median
$25.16
Average
$63.26
Std Dev
$84.29
Max
$294.19
Percentile Distribution (Cost per Claim)
50% of providers bill between $17.00 and $59.26 per claim for this code.
90% bill between $10.44 and $171.99.
Top 1% bill above $286.90.
About This Procedure
HCPCS code 49465 was billed by 19 providers across 3K claims, totaling $408K in Medicaid payments from 2018–2024. This code was used for 3K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$25.16
Providers Billing
17
National Spending
$408K
Avg/Median Ratio
2.51×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for 49465
| # | Provider | Total Paid |
|---|---|---|
| 1 | Egleston Children's Hospital At Emory University Inc. Atlanta, GA · Pediatrics Pediatric Emergency Medicine | $278K |
| 2 | Children's Hospital Of Wisconsin, Inc. Milwaukee, WI · Dentist, Pediatric Dentistry | $60K |
| 3 | 1487608931 | $37K |
| 4 | 1881632818 | $10K |
| 5 | 1942553615 | $8K |
| 6 | State Of Mississippi - University Of Mississippi Medical Center Jackson, MS · General Acute Care Hospital | $5K |
| 7 | Medical University Hospital Authority Charleston, SC · General Acute Care Hospital | $4K |
| 8 | 1225041809 | $2K |
| 9 | 1679529978 | $777 |
| 10 | 1336192863 | $695 |
| 11 | 1871528026 | $477 |
| 12 | Orlando Health Inc. Orlando, FL · General Acute Care Hospital | $454 |
| 13 | 1164474094 | $339 |
| 14 | 1073827101 | $296 |
| 15 | Adventist Health System-sunbelt, Inc Orlando, FL · Ambulance, Land Transport | $264 |
| 16 | 1669423265 | $238 |
| 17 | William Beaumont Hospital Royal Oak, MI · Internal Medicine, Cardiovascular Disease | $225 |
| 18 | Umass Memorial Medical Center, Inc. Worcester, MA · General Acute Care Hospital | $0 |
| 19 | Variety Children's Hospital Miami, FL · General Acute Care Hospital Children | $0 |
Showing top 19 of 19 providers billing this code