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#1618 of 11K

70543

HCPCS Procedure Code

HCPCS code 70543 is the #1,618 most-billed Medicaid procedure code, with $17.6M in payments across 38K claims from 2018–2024. The national median cost per claim is $247.27. Costs vary widely — the 90th percentile is $694.27 per claim, 2.8× the median.

Total Paid

$17.6M

0.00% of all spending

Total Claims

38K

Providers

143

Avg Cost/Claim

$465

National Cost Distribution

How much do providers bill per claim for 70543? Based on 138 providers billing this code nationally.

Median

$247.27

Average

$333.21

Std Dev

$384.29

Max

$2,395.68

Percentile Distribution (Cost per Claim)

p10
$59.30
p25
$96.36
Median
$247.27
p75
$385.77
p90
$694.27
p95
$976.27
p99
$2,065.86

50% of providers bill between $96.36 and $385.77 per claim for this code.

90% bill between $59.30 and $694.27.

Top 1% bill above $2,065.86.

About This Procedure

HCPCS code 70543 was billed by 143 providers across 38K claims, totaling $17.6M in Medicaid payments from 2018–2024. This code was used for 36K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$247.27

Providers Billing

138

National Spending

$17.6M

Avg/Median Ratio

1.35×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 70543

#ProviderTotal Paid
1Scottish Rite Children's Medical Center

Atlanta, GA · Pediatrics Pediatric Hematology-Oncology

$4.1M
2Egleston Children's Hospital At Emory University Inc.

Atlanta, GA · Pediatrics Pediatric Emergency Medicine

$1.5M
3Arkansas Childrens Hospital

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

$1.2M
4University Of Kentucky

Lexington, KY · General Acute Care Hospital

$1.2M
5Phoenix Children's Hospital

Phoenix, AZ · General Acute Care Hospital Children

$1.1M
6Yale New Haven Hospital

New Haven, CT · General Acute Care Hospital

$809K
7Stanford Health Care

Stanford, CA · General Acute Care Hospital

$736K
8Vhs Childrens Hospital Of Michigan Inc

Detroit, MI · Clinic/Center, Ambulatory Surgical

$669K
9Childrens Hospital Of Philadelphia

Philadelphia, PA · General Acute Care Hospital Children

$489K
10Childrens Hospital Of Los Angeles

Los Angeles, CA · Case Manager/Care Coordinator

$320K
111639101751$315K
121689744450$309K
13Beverly Radiology Medical Group Iii

Los Angeles, CA · Radiology, Diagnostic Radiology

$299K
14Children's Hospital Of Wisconsin, Inc.

Milwaukee, WI · Dentist, Pediatric Dentistry

$248K
15Memorial Hospital For Cancer And Allied Diseases

New York, NY · Pharmacy

$220K
16Beth Israel Medical Center

Brooklyn, NY · Psychiatric Unit

$208K
17State Of Mississippi - University Of Mississippi Medical Center

Jackson, MS · General Acute Care Hospital

$204K
18Seventh-day Adventists Loma Linda University Medical Center

Loma Linda, CA · General Acute Care Hospital

$197K
19Regents Of The University Of Michigan

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

$188K
20Montefiore Medical Center

Bronx, NY · General Acute Care Hospital

$186K

Showing top 20 of 143 providers billing this code