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#5903 of 11K

D4921

HCPCS Procedure Code

HCPCS code D4921 is the #5,903 most-billed Medicaid procedure code, with $122K in payments across 78K claims from 2018–2024. The national median cost per claim is $3.02. Costs vary widely — the 90th percentile is $132.17 per claim, 43.8× the median.

Total Paid

$122K

0.00% of all spending

Total Claims

78K

Providers

138

Avg Cost/Claim

$2

National Cost Distribution

How much do providers bill per claim for D4921? Based on 18 providers billing this code nationally.

Median

$3.02

Average

$37.71

Std Dev

$59.64

Max

$184.62

Percentile Distribution (Cost per Claim)

p10
$0.03
p25
$0.87
Median
$3.02
p75
$51.95
p90
$132.17
p95
$149.83
p99
$177.66

50% of providers bill between $0.87 and $51.95 per claim for this code.

90% bill between $0.03 and $132.17.

Top 1% bill above $177.66.

About This Procedure

HCPCS code D4921 was billed by 138 providers across 78K claims, totaling $122K in Medicaid payments from 2018–2024. This code was used for 25K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$3.02

Providers Billing

18

National Spending

$122K

Avg/Median Ratio

12.49×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for D4921

#ProviderTotal Paid
11841308087$65K
21114386380$19K
31497020119$17K
41407008154$14K
51710275235$2K
61801430913$1K
71720518699$1K
81538225503$760
91144332701$465
101881922193$402
111922261882$320
121073702767$187
131972877017$114
141982775458$98
151538399324$92
161972674448$92
171508349606$60
181043335987$22
191760546337$0
201316497134$0

Showing top 20 of 138 providers billing this code