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#5057 of 11K

78434

HCPCS Procedure Code

HCPCS code 78434 is the #5,057 most-billed Medicaid procedure code, with $306K in payments across 18K claims from 2018–2024. The national median cost per claim is $12.49. Costs vary widely — the 90th percentile is $59.49 per claim, 4.8× the median.

Total Paid

$306K

0.00% of all spending

Total Claims

18K

Providers

89

Avg Cost/Claim

$17

National Cost Distribution

How much do providers bill per claim for 78434? Based on 71 providers billing this code nationally.

Median

$12.49

Average

$23.63

Std Dev

$30.27

Max

$166.12

Percentile Distribution (Cost per Claim)

p10
$1.24
p25
$5.47
Median
$12.49
p75
$25.50
p90
$59.49
p95
$79.41
p99
$134.34

50% of providers bill between $5.47 and $25.50 per claim for this code.

90% bill between $1.24 and $59.49.

Top 1% bill above $134.34.

About This Procedure

HCPCS code 78434 was billed by 89 providers across 18K claims, totaling $306K in Medicaid payments from 2018–2024. This code was used for 17K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$12.49

Providers Billing

71

National Spending

$306K

Avg/Median Ratio

1.89×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for 78434

#ProviderTotal Paid
11770830606$62K
21063851335$54K
31255382545$27K
4Ohiohealth Corporation

Columbus, OH · General Acute Care Hospital

$21K
5St Lukes Roosevelt Hospital Center

New York, NY · Case Management

$14K
61952338212$13K
71043279565$12K
8Yale University

New Haven, CT · Internal Medicine

$8K
91194749580$7K
101982833398$6K
111336147859$6K
121558759571$5K
131043220650$5K
141932675824$5K
151043233984$4K
16Trustees Of The University Of Pennsylvania

Philadelphia, PA · Community/Behavioral Health

$4K
171740213446$4K
181811431182$3K
191194723601$3K
201063886323$3K

Showing top 20 of 89 providers billing this code

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