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#2849 of 11K

96521

HCPCS Procedure Code

HCPCS code 96521 is the #2,849 most-billed Medicaid procedure code, with $3.3M in payments across 39K claims from 2018–2024. The national median cost per claim is $32.64. Costs vary widely — the 90th percentile is $107.60 per claim, 3.3× the median.

Total Paid

$3.3M

0.00% of all spending

Total Claims

39K

Providers

41

Avg Cost/Claim

$86

National Cost Distribution

How much do providers bill per claim for 96521? Based on 38 providers billing this code nationally.

Median

$32.64

Average

$45.68

Std Dev

$39.78

Max

$143.27

Percentile Distribution (Cost per Claim)

p10
$3.68
p25
$13.47
Median
$32.64
p75
$76.22
p90
$107.60
p95
$111.43
p99
$131.60

50% of providers bill between $13.47 and $76.22 per claim for this code.

90% bill between $3.68 and $107.60.

Top 1% bill above $131.60.

About This Procedure

HCPCS code 96521 was billed by 41 providers across 39K claims, totaling $3.3M in Medicaid payments from 2018–2024. This code was used for 10K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$32.64

Providers Billing

38

National Spending

$3.3M

Avg/Median Ratio

1.40×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 96521

#ProviderTotal Paid
11639403330$2.2M
21790706992$238K
31902191992$184K
41790130573$139K
51366659849$88K
61437109733$80K
71588805188$48K
81093263055$42K
91700017118$36K
101053373480$36K
111619581246$31K
121104984293$24K
131063177228$22K
141548248032$22K
151831300805$22K
161407100183$20K
171225525256$18K
181669102612$16K
191568059160$16K
201831656354$12K

Showing top 20 of 41 providers billing this code

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