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#5044 of 11K

21235

HCPCS Procedure Code

HCPCS code 21235 is the #5,044 most-billed Medicaid procedure code, with $308K in payments across 285 claims from 2018–2024. The national median cost per claim is $1,522.91.

Total Paid

$308K

0.00% of all spending

Total Claims

285

Providers

4

Avg Cost/Claim

$1K

National Cost Distribution

How much do providers bill per claim for 21235? Based on 4 providers billing this code nationally.

Median

$1,522.91

Average

$1,575.11

Std Dev

$905.22

Max

$2,541.10

Percentile Distribution (Cost per Claim)

p10
$769.31
p25
$852.98
Median
$1,522.91
p75
$2,245.05
p90
$2,422.68
p95
$2,481.89
p99
$2,529.26

50% of providers bill between $852.98 and $2,245.05 per claim for this code.

90% bill between $769.31 and $2,422.68.

Top 1% bill above $2,529.26.

About This Procedure

HCPCS code 21235 was billed by 4 providers across 285 claims, totaling $308K in Medicaid payments from 2018–2024. This code was used for 280 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$1,522.91

Providers Billing

4

National Spending

$308K

Avg/Median Ratio

1.03×

Normal distribution

Provider Coverage

We have 4 providers billing this code in our dataset. Individual provider breakdowns are available for top-spending procedure codes.