78454
HCPCS Procedure Code
HCPCS code 78454 is the #4,716 most-billed Medicaid procedure code, with $436K in payments across 7K claims from 2018–2024. The national median cost per claim is $26.12. Costs vary widely — the 90th percentile is $166.13 per claim, 6.4× the median.
Total Paid
$436K
0.00% of all spending
Total Claims
7K
Providers
45
Avg Cost/Claim
$60
National Cost Distribution
How much do providers bill per claim for 78454? Based on 45 providers billing this code nationally.
Median
$26.12
Average
$73.12
Std Dev
$115.60
Max
$588.41
Percentile Distribution (Cost per Claim)
50% of providers bill between $19.49 and $70.11 per claim for this code.
90% bill between $14.21 and $166.13.
Top 1% bill above $513.53.
About This Procedure
HCPCS code 78454 was billed by 45 providers across 7K claims, totaling $436K in Medicaid payments from 2018–2024. This code was used for 7K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$26.12
Providers Billing
45
National Spending
$436K
Avg/Median Ratio
2.80×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for 78454
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1023010113 | $83K |
| 2 | 1912992553 | $46K |
| 3 | 1649270257 | $45K |
| 4 | 1487608931 | $39K |
| 5 | 1891938122 | $25K |
| 6 | 1568461440 | $23K |
| 7 | 1528299989 | $21K |
| 8 | Temple University Hospital Inc Philadelphia, PA · General Acute Care Hospital | $19K |
| 9 | 1306842521 | $19K |
| 10 | 1730171265 | $17K |
| 11 | 1992975775 | $15K |
| 12 | 1609869916 | $11K |
| 13 | 1215394036 | $9K |
| 14 | 1821196361 | $8K |
| 15 | 1013069657 | $7K |
| 16 | 1811996960 | $7K |
| 17 | 1730209545 | $6K |
| 18 | 1669422630 | $5K |
| 19 | 1720023997 | $4K |
| 20 | 1518134402 | $3K |
Showing top 20 of 45 providers billing this code