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#2535 of 11K

46221

HCPCS Procedure Code

HCPCS code 46221 is the #2,535 most-billed Medicaid procedure code, with $5.1M in payments across 30K claims from 2018–2024. The national median cost per claim is $120.31. Costs vary widely — the 90th percentile is $249.40 per claim, 2.1× the median.

Total Paid

$5.1M

0.00% of all spending

Total Claims

30K

Providers

82

Avg Cost/Claim

$172

National Cost Distribution

How much do providers bill per claim for 46221? Based on 80 providers billing this code nationally.

Median

$120.31

Average

$146.76

Std Dev

$126.70

Max

$801.78

Percentile Distribution (Cost per Claim)

p10
$43.90
p25
$70.98
Median
$120.31
p75
$183.61
p90
$249.40
p95
$334.45
p99
$610.37

50% of providers bill between $70.98 and $183.61 per claim for this code.

90% bill between $43.90 and $249.40.

Top 1% bill above $610.37.

About This Procedure

HCPCS code 46221 was billed by 82 providers across 30K claims, totaling $5.1M in Medicaid payments from 2018–2024. This code was used for 25K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$120.31

Providers Billing

80

National Spending

$5.1M

Avg/Median Ratio

1.22×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 46221

#ProviderTotal Paid
11770823551$1.3M
21073923561$562K
31376774208$490K
41356654610$396K
51962526509$301K
61346880838$232K
71730322645$199K
81487677951$184K
91598966301$182K
101154398568$142K
111689612954$103K
121225053523$85K
131922099415$82K
141548419005$77K
151932202959$71K
161417446501$70K
171083742357$55K
181063593739$53K
191669554887$51K
201386971687$50K

Showing top 20 of 82 providers billing this code

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