69421
HCPCS Procedure Code
HCPCS code 69421 is the #5,595 most-billed Medicaid procedure code, with $170K in payments across 426 claims from 2018–2024. The national median cost per claim is $176.91. Costs vary widely — the 90th percentile is $1,210.34 per claim, 6.8× the median.
Total Paid
$170K
0.00% of all spending
Total Claims
426
Providers
9
Avg Cost/Claim
$400
National Cost Distribution
How much do providers bill per claim for 69421? Based on 9 providers billing this code nationally.
Median
$176.91
Average
$493.46
Std Dev
$554.21
Max
$1,495.42
Percentile Distribution (Cost per Claim)
50% of providers bill between $160.63 and $993.80 per claim for this code.
90% bill between $73.93 and $1,210.34.
Top 1% bill above $1,466.91.
About This Procedure
HCPCS code 69421 was billed by 9 providers across 426 claims, totaling $170K in Medicaid payments from 2018–2024. This code was used for 351 unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$176.91
Providers Billing
9
National Spending
$170K
Avg/Median Ratio
2.79×
Highly skewed — outlier-driven
Top Providers Billing This Code
Ranked by total Medicaid payments for 69421
| # | Provider | Total Paid |
|---|---|---|
| 1 | 1003865999 | $66K |
| 2 | Hmh Hospitals Corporation Neptune, NJ · General Acute Care Hospital | $43K |
| 3 | 1710943881 | $25K |
| 4 | University Of Kentucky Lexington, KY · General Acute Care Hospital | $14K |
| 5 | 1043361116 | $10K |
| 6 | Ou Health Partners, Inc Oklahoma City, OK · Clinic/Center, Multi-Specialty | $7K |
| 7 | 1265496236 | $2K |
| 8 | 1417905324 | $2K |
| 9 | 1356860811 | $2K |
Showing top 9 of 9 providers billing this code