Statistical flags indicate unusual patterns — not proof of fraud or wrongdoing. Read our methodology

#6545 of 11K

10021

HCPCS Procedure Code

HCPCS code 10021 is the #6,545 most-billed Medicaid procedure code, with $57K in payments across 1,100 claims from 2018–2024. The national median cost per claim is $35.05. Costs vary widely — the 90th percentile is $179.58 per claim, 5.1× the median.

Total Paid

$57K

0.00% of all spending

Total Claims

1,100

Providers

9

Avg Cost/Claim

$52

National Cost Distribution

How much do providers bill per claim for 10021? Based on 9 providers billing this code nationally.

Median

$35.05

Average

$82.30

Std Dev

$144.92

Max

$458.98

Percentile Distribution (Cost per Claim)

p10
$6.94
p25
$9.25
Median
$35.05
p75
$51.05
p90
$179.58
p95
$319.28
p99
$431.04

50% of providers bill between $9.25 and $51.05 per claim for this code.

90% bill between $6.94 and $179.58.

Top 1% bill above $431.04.

About This Procedure

HCPCS code 10021 was billed by 9 providers across 1,100 claims, totaling $57K in Medicaid payments from 2018–2024. This code was used for 1,025 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$35.05

Providers Billing

9

National Spending

$57K

Avg/Median Ratio

2.35×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for 10021

#ProviderTotal Paid
11093758773$22K
2Memorial Hospital For Cancer And Allied Diseases

New York, NY · Pharmacy

$13K
3Englewood Hospital And Medical Center

Englewood, NJ · General Acute Care Hospital

$12K
41891894986$5K
51619082625$2K
61710240841$1K
71306811930$955
81225003346$314
91699986331$96

Showing top 9 of 9 providers billing this code

Related Procedures