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#3311 of 11K

X0043

HCPCS Procedure Code

HCPCS code X0043 is the #3,311 most-billed Medicaid procedure code, with $2.0M in payments across 7,607 claims from 2018–2024. The national median cost per claim is $444.11. Costs vary widely — the 90th percentile is $896.92 per claim, 2.0× the median.

Total Paid

$2.0M

0.00% of all spending

Total Claims

7,607

Providers

7

Avg Cost/Claim

$257

National Cost Distribution

How much do providers bill per claim for X0043? Based on 6 providers billing this code nationally.

Median

$444.11

Average

$542.59

Std Dev

$296.62

Max

$984.02

Percentile Distribution (Cost per Claim)

p10
$286.73
p25
$392.24
Median
$444.11
p75
$727.97
p90
$896.92
p95
$940.47
p99
$975.31

50% of providers bill between $392.24 and $727.97 per claim for this code.

90% bill between $286.73 and $896.92.

Top 1% bill above $975.31.

About This Procedure

HCPCS code X0043 was billed by 7 providers across 7,607 claims, totaling $2.0M in Medicaid payments from 2018–2024. This code was used for 1,437 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$444.11

Providers Billing

6

National Spending

$2.0M

Avg/Median Ratio

1.22×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for X0043

#ProviderTotal Paid
11326139023$962K
21184073058$784K
31972587699$66K
41497826515$62K
51720390818$61K
61043219553$23K
71609955822$0

Showing top 7 of 7 providers billing this code