#2041 of 11K

54300

HCPCS Procedure Code

HCPCS code 54300 is the #2,041 most-billed Medicaid procedure code, with $9.8M in payments across 12K claims from 2018–2024. The national median cost per claim is $588.34. Costs vary widely — the 90th percentile is $1,550.49 per claim, 2.6× the median.

Total Paid

$9.8M

0.00% of all spending

Total Claims

12K

Providers

Avg Cost/Claim

$816

National Cost Distribution

How much do providers bill per claim for 54300? Based on 77 providers billing this code nationally.

Median

$588.34

Average

$802.14

Std Dev

$601.67

Max

$3,106.89

Percentile Distribution (Cost per Claim)

p10

$304.40

p25

$415.32

Median

$588.34

p75

$992.29

p90

$1,550.49

p95

$1,975.38

p99

$2,869.84

50% of providers bill between $415.32 and $992.29 per claim for this code.

90% bill between $304.40 and $1,550.49.

Top 1% bill above $2,869.84.

About This Procedure

HCPCS code 54300 was billed by 77 providers across 12K claims, totaling $9.8M in Medicaid payments from 2018–2024. This code was used for 11K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$588.34

Providers Billing

National Spending

$9.8M

Avg/Median Ratio

1.36×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 54300

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	The Nemours Foundation Orlando, FL · General Acute Care Hospital Children	$1.3M	$1,403.91	2.4× median	Above 75th
2	Phoenix Children's Hospital Phoenix, AZ · General Acute Care Hospital Children	$1.2M	$1,533.76	2.6× median	Above 75th
3	1104877141	$1.2M	$593.64	1.0× median	Above Median
4	1861439952	$864K	$1,180.25	2.0× median	Above 75th
5	1518989193	$655K	$963.29	1.6× median	Above Median
6	Norton Hospitals Inc Louisville, KY · General Acute Care Hospital	$532K	$1,040.01	1.8× median	Above 75th
7	Norton Hospitals, Inc Louisville, KY · General Acute Care Hospital	$342K	$610.48	1.0× median	Above Median
8	1831189638	$331K	$826.51	1.4× median	Above Median
9	Nemours Children's Health, Downtown Orlando, Specialty Care Orlando, FL · Clinic/Center, Multi-Specialty	$318K	$1,048.09	1.8× median	Above 75th
10	The Nemours Foundation Jacksonville, FL · Clinic/Center Multi-Specialty	$243K	$1,135.68	1.9× median	Above 75th
11	1093024101	$203K	$601.03	1.0× median	Above Median
12	1245808534	$190K	$1,328.88	2.3× median	Above 75th
13	Ochsner Clinic Foundation New Orleans, LA · General Acute Care Hospital	$179K	$308.22	0.5× median	Below Median
14	1477951770	$178K	$667.34	1.1× median	Above Median
15	1306952726	$169K	$1,759.66	3.0× median	Top 10%
16	Wake Forest University Health Sciences Winston Salem, NC · Clinic/Center, Multi-Specialty	$155K	$510.57	0.9× median	Below Median
17	Ochsner Clinic Llc New Orleans, LA · Surgery	$150K	$298.67	0.5× median	Below Median
18	1245654342	$132K	$1,202.62	2.0× median	Above 75th
19	1548332968	$114K	$386.03	0.7× median	Below Median
20	North Shore-lij Medical Pc Great Neck, NY · Urology	$70K	$702.26	1.2× median	Above Median

Showing top 20 of 77 providers billing this code

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