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#762 of 11K

X4003

HCPCS Procedure Code

HCPCS code X4003 is the #762 most-billed Medicaid procedure code, with $86.7M in payments across 1.0M claims from 2018–2024. The national median cost per claim is $74.03. Costs vary widely — the 90th percentile is $179.78 per claim, 2.4× the median.

Total Paid

$86.7M

0.01% of all spending

Total Claims

1.0M

Providers

75

Avg Cost/Claim

$86

National Cost Distribution

How much do providers bill per claim for X4003? Based on 75 providers billing this code nationally.

Median

$74.03

Average

$111.09

Std Dev

$130.60

Max

$834.92

Percentile Distribution (Cost per Claim)

p10
$36.99
p25
$55.03
Median
$74.03
p75
$120.29
p90
$179.78
p95
$269.42
p99
$752.79

50% of providers bill between $55.03 and $120.29 per claim for this code.

90% bill between $36.99 and $179.78.

Top 1% bill above $752.79.

About This Procedure

HCPCS code X4003 was billed by 75 providers across 1.0M claims, totaling $86.7M in Medicaid payments from 2018–2024. This code was used for 882K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$74.03

Providers Billing

75

National Spending

$86.7M

Avg/Median Ratio

1.50×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for X4003

#ProviderTotal Paid
1The Children's Mercy Hospital

Kansas City, MO · General Acute Care Hospital Children

$24.3M
2Truman Medical Center, Incorporated

Kansas City, MO · General Acute Care Hospital

$9.2M
3Curators Of The University Of Missouri

Columbia, MO · General Acute Care Hospital

$7.8M
41437259694$6.0M
51962572396$3.5M
61265546048$3.5M
71568643005$3.3M
81376686600$3.2M
91912109919$2.9M
101649299827$2.8M
111952629370$2.5M
121467412726$1.7M
131508935891$1.7M
141093740128$1.6M
151538200357$1.5M
161871698472$1.3M
171598835308$1.3M
181831115641$1.3M
191578504056$589K
201831269539$450K

Showing top 20 of 75 providers billing this code