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

#4552 of 11K

D4266

HCPCS Procedure Code

HCPCS code D4266 is the #4,552 most-billed Medicaid procedure code, with $518K in payments across 2,263 claims from 2018–2024. The national median cost per claim is $259.60.

Total Paid

$518K

0.00% of all spending

Total Claims

2,263

Providers

9

Avg Cost/Claim

$229

National Cost Distribution

How much do providers bill per claim for D4266? Based on 6 providers billing this code nationally.

Median

$259.60

Average

$265.73

Std Dev

$144.20

Max

$507.66

Percentile Distribution (Cost per Claim)

p10
$128.51
p25
$189.50
Median
$259.60
p75
$304.38
p90
$409.08
p95
$458.37
p99
$497.80

50% of providers bill between $189.50 and $304.38 per claim for this code.

90% bill between $128.51 and $409.08.

Top 1% bill above $497.80.

About This Procedure

HCPCS code D4266 was billed by 9 providers across 2,263 claims, totaling $518K in Medicaid payments from 2018–2024. This code was used for 899 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$259.60

Providers Billing

6

National Spending

$518K

Avg/Median Ratio

1.02×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for D4266

#ProviderTotal Paid
11861689309$226K
21508477050$137K
31942643564$128K
41134584055$17K
51295961829$8K
61730287673$2K
71215298757$0
81366985491$0
91376972554$0

Showing top 9 of 9 providers billing this code