M0243
HCPCS Procedure Code
HCPCS code M0243 is the #1,820 most-billed Medicaid procedure code, with $13.3M in payments across 74K claims from 2018–2024. The national median cost per claim is $215.21.
Total Paid
$13.3M
0.00% of all spending
Total Claims
74K
Providers
862
Avg Cost/Claim
$181
National Cost Distribution
How much do providers bill per claim for M0243? Based on 787 providers billing this code nationally.
Median
$215.21
Average
$214.67
Std Dev
$127.76
Max
$1,439.19
Percentile Distribution (Cost per Claim)
50% of providers bill between $126.53 and $297.23 per claim for this code.
90% bill between $40.49 and $378.19.
Top 1% bill above $477.99.
About This Procedure
HCPCS code M0243 was billed by 862 providers across 74K claims, totaling $13.3M in Medicaid payments from 2018–2024. This code was used for 64K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$215.21
Providers Billing
787
National Spending
$13.3M
Avg/Median Ratio
1.00×
Normal distribution
Top Providers Billing This Code
Ranked by total Medicaid payments for M0243
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1295723229 | $317K |
| 2 | 1497352587 | $309K |
| 3 | Ochsner Clinic Foundation New Orleans, LA · General Acute Care Hospital | $230K |
| 4 | Norton Hospitals Inc Louisville, KY · General Acute Care Hospital | $208K |
| 5 | 1598766495 | $204K |
| 6 | 1215939210 | $160K |
| 7 | Banner-university Medical Group Phoenix, AZ · Clinic/Center, Primary Care | $150K |
| 8 | 1275536799 | $130K |
| 9 | 1154365062 | $129K |
| 10 | 1629201264 | $126K |
| 11 | Presbyterian Healthcare Services Albuquerque, NM · Emergency Medicine | $124K |
| 12 | 1871955807 | $120K |
| 13 | Spectrum Health Hospitals Grand Rapids, MI · General Acute Care Hospital | $119K |
| 14 | Umass Memorial Medical Center, Inc. Worcester, MA · General Acute Care Hospital | $118K |
| 15 | Driscoll Childrens Hospital Corpus Christi, TX · Speech-Language Pathologist, | $114K |
| 16 | 1053360651 | $110K |
| 17 | Baptist Healthcare System Inc Corbin, KY · General Acute Care Hospital | $107K |
| 18 | 1396761805 | $97K |
| 19 | 1932865607 | $94K |
| 20 | 1629027578 | $91K |
Showing top 20 of 862 providers billing this code