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#1356 of 11K

98943

HCPCS Procedure Code

HCPCS code 98943 is the #1,356 most-billed Medicaid procedure code, with $25.9M in payments across 2.0M claims from 2018–2024. The national median cost per claim is $14.25.

Total Paid

$25.9M

0.00% of all spending

Total Claims

2.0M

Providers

885

Avg Cost/Claim

$13

National Cost Distribution

How much do providers bill per claim for 98943? Based on 767 providers billing this code nationally.

Median

$14.25

Average

$13.24

Std Dev

$5.95

Max

$38.56

Percentile Distribution (Cost per Claim)

p10
$4.44
p25
$10.23
Median
$14.25
p75
$17.12
p90
$19.60
p95
$21.24
p99
$26.82

50% of providers bill between $10.23 and $17.12 per claim for this code.

90% bill between $4.44 and $19.60.

Top 1% bill above $26.82.

About This Procedure

HCPCS code 98943 was billed by 885 providers across 2.0M claims, totaling $25.9M in Medicaid payments from 2018–2024. This code was used for 772K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$14.25

Providers Billing

767

National Spending

$25.9M

Avg/Median Ratio

0.93×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 98943

#ProviderTotal Paid
11427022946$902K
21780988261$484K
31013642198$398K
41689846560$347K
51669081626$332K
61952509416$315K
71750508644$285K
81275921660$280K
91801381470$262K
101720366081$241K
111790337020$240K
121699980383$234K
131871693770$229K
141235196114$227K
151407126303$227K
161053315770$226K
171376184564$207K
181457535973$202K
191760537898$199K
201659458487$198K

Showing top 20 of 885 providers billing this code