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#5305 of 11K

21040

HCPCS Procedure Code

HCPCS code 21040 is the #5,305 most-billed Medicaid procedure code, with $233K in payments across 1,091 claims from 2018–2024. The national median cost per claim is $208.66.

Total Paid

$233K

0.00% of all spending

Total Claims

1,091

Providers

2

Avg Cost/Claim

$214

National Cost Distribution

How much do providers bill per claim for 21040? Based on 2 providers billing this code nationally.

Median

$208.66

Average

$208.66

Std Dev

$27.03

Max

$227.77

Percentile Distribution (Cost per Claim)

p10
$193.37
p25
$199.11
Median
$208.66
p75
$218.22
p90
$223.95
p95
$225.86
p99
$227.39

50% of providers bill between $199.11 and $218.22 per claim for this code.

90% bill between $193.37 and $223.95.

Top 1% bill above $227.39.

About This Procedure

HCPCS code 21040 was billed by 2 providers across 1,091 claims, totaling $233K in Medicaid payments from 2018–2024. This code was used for 881 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$208.66

Providers Billing

2

National Spending

$233K

Avg/Median Ratio

1.00×

Normal distribution

Provider Coverage

We have 2 providers billing this code in our dataset. Individual provider breakdowns are available for top-spending procedure codes.