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

#7880 of 11K

36216

HCPCS Procedure Code

HCPCS code 36216 is the #7,880 most-billed Medicaid procedure code, with $9K in payments across 141 claims from 2018–2024. The national median cost per claim is $59.41. Costs vary widely — the 90th percentile is $119.45 per claim, 2.0× the median.

Total Paid

$9K

0.00% of all spending

Total Claims

141

Providers

3

Avg Cost/Claim

$62

National Cost Distribution

How much do providers bill per claim for 36216? Based on 3 providers billing this code nationally.

Median

$59.41

Average

$67.44

Std Dev

$63.38

Max

$134.46

Percentile Distribution (Cost per Claim)

p10
$18.65
p25
$33.94
Median
$59.41
p75
$96.94
p90
$119.45
p95
$126.95
p99
$132.96

50% of providers bill between $33.94 and $96.94 per claim for this code.

90% bill between $18.65 and $119.45.

Top 1% bill above $132.96.

About This Procedure

HCPCS code 36216 was billed by 3 providers across 141 claims, totaling $9K in Medicaid payments from 2018–2024. This code was used for 137 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$59.41

Providers Billing

3

National Spending

$9K

Avg/Median Ratio

1.14×

Normal distribution

Provider Coverage

We have 3 providers billing this code in our dataset. Individual provider breakdowns are available for top-spending procedure codes.