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#2170 of 11K

78492

HCPCS Procedure Code

HCPCS code 78492 is the #2,170 most-billed Medicaid procedure code, with $8.3M in payments across 35K claims from 2018–2024. The national median cost per claim is $54.47. Costs vary widely — the 90th percentile is $531.49 per claim, 9.8× the median.

Total Paid

$8.3M

0.00% of all spending

Total Claims

35K

Providers

117

Avg Cost/Claim

$239

National Cost Distribution

How much do providers bill per claim for 78492? Based on 108 providers billing this code nationally.

Median

$54.47

Average

$200.91

Std Dev

$293.21

Max

$1,298.99

Percentile Distribution (Cost per Claim)

p10
$4.56
p25
$14.48
Median
$54.47
p75
$274.33
p90
$531.49
p95
$912.25
p99
$1,232.28

50% of providers bill between $14.48 and $274.33 per claim for this code.

90% bill between $4.56 and $531.49.

Top 1% bill above $1,232.28.

About This Procedure

HCPCS code 78492 was billed by 117 providers across 35K claims, totaling $8.3M in Medicaid payments from 2018–2024. This code was used for 32K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$54.47

Providers Billing

108

National Spending

$8.3M

Avg/Median Ratio

3.69×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for 78492

#ProviderTotal Paid
11336147859$2.7M
21730137480$1.4M
31194723601$850K
4Yale New Haven Hospital

New Haven, CT · General Acute Care Hospital

$354K
5Norton Hospitals Inc

Louisville, KY · General Acute Care Hospital

$296K
61245218619$253K
71306876065$206K
81750846614$194K
9Carilion Medical Center

Roanoke, VA · General Acute Care Hospital

$152K
101710909585$149K
111831248236$134K
121144265547$127K
131770830606$101K
141104870187$94K
151538252457$88K
161639172372$79K
17Boston Medical Center Corporation

Boston, MA · General Acute Care Hospital

$77K
181255382545$73K
191023073525$68K
201316308406$59K

Showing top 20 of 117 providers billing this code

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