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#5468 of 11K

40806

HCPCS Procedure Code

HCPCS code 40806 is the #5,468 most-billed Medicaid procedure code, with $193K in payments across 1,776 claims from 2018–2024. The national median cost per claim is $32.95. Costs vary widely — the 90th percentile is $106.33 per claim, 3.2× the median.

Total Paid

$193K

0.00% of all spending

Total Claims

1,776

Providers

12

Avg Cost/Claim

$109

National Cost Distribution

How much do providers bill per claim for 40806? Based on 12 providers billing this code nationally.

Median

$32.95

Average

$125.38

Std Dev

$313.84

Max

$1,117.89

Percentile Distribution (Cost per Claim)

p10
$10.37
p25
$16.00
Median
$32.95
p75
$45.88
p90
$106.33
p95
$564.88
p99
$1,007.29

50% of providers bill between $16.00 and $45.88 per claim for this code.

90% bill between $10.37 and $106.33.

Top 1% bill above $1,007.29.

About This Procedure

HCPCS code 40806 was billed by 12 providers across 1,776 claims, totaling $193K in Medicaid payments from 2018–2024. This code was used for 1,406 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$32.95

Providers Billing

12

National Spending

$193K

Avg/Median Ratio

3.81×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for 40806

#ProviderTotal Paid
1Suny Health Science Center At Syracuse

Syracuse, NY · General Acute Care Hospital

$139K
21629263181$34K
3Children's Hospital Medical Center Of Akron

Akron, OH · General Acute Care Hospital Children

$8K
4Vanderbilt University Medical Center

Nashville, TN · Transplant Surgery

$5K
51124464995$3K
61154636066$1K
71265417174$825
81730939232$512
91184123150$474
10Vanderbilt University Medical Center

Nashville, TN · Psychiatric Unit

$438
11Dayton Children's Hospital

Dayton, OH · General Acute Care Hospital, Children

$231
121841328853$145

Showing top 12 of 12 providers billing this code