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#1504 of 11K

74230

HCPCS Procedure Code

HCPCS code 74230 is the #1,504 most-billed Medicaid procedure code, with $20.9M in payments across 387K claims from 2018–2024. The national median cost per claim is $19.67. Costs vary widely — the 90th percentile is $107.03 per claim, 5.4× the median.

Total Paid

$20.9M

0.00% of all spending

Total Claims

387K

Providers

694

Avg Cost/Claim

$54

National Cost Distribution

How much do providers bill per claim for 74230? Based on 688 providers billing this code nationally.

Median

$19.67

Average

$43.26

Std Dev

$66.74

Max

$914.23

Percentile Distribution (Cost per Claim)

p10
$5.36
p25
$10.84
Median
$19.67
p75
$51.23
p90
$107.03
p95
$145.81
p99
$249.19

50% of providers bill between $10.84 and $51.23 per claim for this code.

90% bill between $5.36 and $107.03.

Top 1% bill above $249.19.

About This Procedure

HCPCS code 74230 was billed by 694 providers across 387K claims, totaling $20.9M in Medicaid payments from 2018–2024. This code was used for 356K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$19.67

Providers Billing

688

National Spending

$20.9M

Avg/Median Ratio

2.20×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for 74230

#ProviderTotal Paid
1Scottish Rite Children's Medical Center

Atlanta, GA · Pediatrics Pediatric Hematology-Oncology

$2.7M
2Egleston Children's Hospital At Emory University Inc.

Atlanta, GA · Pediatrics Pediatric Emergency Medicine

$1.6M
3Phoenix Children's Hospital

Phoenix, AZ · General Acute Care Hospital Children

$960K
41689744450$833K
5Children's Hospital Corporation

Boston, MA · Clinic/Center

$746K
6Medical University Hospital Authority

Charleston, SC · General Acute Care Hospital

$384K
7Johns Hopkins All Children's Hospital Inc

St Petersburg, FL · General Acute Care Hospital Children

$381K
8Yale New Haven Hospital

New Haven, CT · General Acute Care Hospital

$378K
9Children's Hospital Medical Center Of Akron

Akron, OH · General Acute Care Hospital Children

$358K
10University Of Kentucky

Lexington, KY · General Acute Care Hospital

$332K
11Arkansas Childrens Hospital

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

$268K
121144268145$260K
13Virginia Commonwealth University Health System Authority

Richmond, VA · General Acute Care Hospital

$257K
14Children's Hospital Of Wisconsin, Inc.

Milwaukee, WI · Dentist, Pediatric Dentistry

$250K
15Ihc Health Services, Inc.

Salt Lake City, UT · Psychiatric Unit

$245K
161336533041$233K
17Norton Hospitals Inc

Louisville, KY · General Acute Care Hospital

$232K
18Connecticut Children's Medical Center

Hartford, CT · General Acute Care Hospital, Children

$227K
191902835895$214K
201386709871$207K

Showing top 20 of 694 providers billing this code