#7078 of 11K

74430

HCPCS Procedure Code

HCPCS code 74430 is the #7,078 most-billed Medicaid procedure code, with $29K in payments across 1,057 claims from 2018–2024. The national median cost per claim is $15.63. Costs vary widely — the 90th percentile is $143.20 per claim, 9.2× the median.

Total Paid

$29K

0.00% of all spending

Total Claims

1,057

Providers

Avg Cost/Claim

$28

National Cost Distribution

How much do providers bill per claim for 74430? Based on 15 providers billing this code nationally.

Median

$15.63

Average

$46.01

Std Dev

$60.52

Max

$182.54

Percentile Distribution (Cost per Claim)

p10

$4.74

p25

$9.01

Median

$15.63

p75

$55.92

p90

$143.20

p95

$180.46

p99

$182.12

50% of providers bill between $9.01 and $55.92 per claim for this code.

90% bill between $4.74 and $143.20.

Top 1% bill above $182.12.

About This Procedure

HCPCS code 74430 was billed by 18 providers across 1,057 claims, totaling $29K in Medicaid payments from 2018–2024. This code was used for 971 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$15.63

Providers Billing

National Spending

$29K

Avg/Median Ratio

2.94×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for 74430

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	University Of Kentucky Lexington, KY · General Acute Care Hospital	$13K	$182.54	11.7× median	Top 1%
2	University Of Cincinnati Medical Center, Llc Cincinnati, OH · General Acute Care Hospital	$5K	$77.49	5.0× median	Above 75th
3	Tucson Medical Center Tucson, AZ · Clinic/Center, Hearing and Speech	$3K	$4.75	0.3× median	Below Median
4	1346297843	$3K	$179.57	11.5× median	Top 10%
5	1790727550	$2K	$88.64	5.7× median	Above 75th
6	1245365196	$859	$34.35	2.2× median	Above Median
7	1326695255	$508	$12.69	0.8× median	Below Median
8	Beth Israel Medical Center Brooklyn, NY · Psychiatric Unit	$439	$33.77	2.2× median	Above Median
9	Vanderbilt University Medical Center Nashville, TN · Transplant Surgery	$391	$15.63	1.0× median	Above Median
10	1093768723	$279	$23.26	1.5× median	Above Median
11	1699979732	$171	$4.74	0.3× median	Below Median
12	1386698710	$134	$10.29	0.7× median	Below Median
13	1285930016	$116	$4.45	0.3× median	Below Median
14	1679529978	$115	$9.59	0.6× median	Below Median
15	1659310092	$101	$8.44	0.5× median	Below Median
16	1154435824	$0	$0.00	0.0× median	Below Median
17	Seattle Children's Hospital Seattle, WA · Prosthetic/Orthotic Supplier	$0	$0.00	0.0× median	Below Median
18	Oakwood Healthcare, Inc. Dearborn, MI · General Acute Care Hospital	$0	$0.00	0.0× median	Below Median

Showing top 18 of 18 providers billing this code

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