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

#5166 of 11K

D9215

HCPCS Procedure Code

HCPCS code D9215 is the #5,166 most-billed Medicaid procedure code, with $271K in payments across 116K claims from 2018–2024. The national median cost per claim is $1.89. Costs vary widely — the 90th percentile is $28.69 per claim, 15.2× the median.

Total Paid

$271K

0.00% of all spending

Total Claims

116K

Providers

177

Avg Cost/Claim

$2

National Cost Distribution

How much do providers bill per claim for D9215? Based on 43 providers billing this code nationally.

Median

$1.89

Average

$9.68

Std Dev

$23.88

Max

$131.57

Percentile Distribution (Cost per Claim)

p10
$0.08
p25
$0.17
Median
$1.89
p75
$5.09
p90
$28.69
p95
$57.62
p99
$101.00

50% of providers bill between $0.17 and $5.09 per claim for this code.

90% bill between $0.08 and $28.69.

Top 1% bill above $101.00.

About This Procedure

HCPCS code D9215 was billed by 177 providers across 116K claims, totaling $271K in Medicaid payments from 2018–2024. This code was used for 98K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$1.89

Providers Billing

43

National Spending

$271K

Avg/Median Ratio

5.12×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for D9215

#ProviderTotal Paid
1Department Of Intellectual And Developmental Disabilities, State Of Tn

Nashville, TN · Public Health or Welfare

$163K
2Department Of Intellectual And Developmental Disabilities, State Of Tn

Nashville, TN · Public Health or Welfare

$33K
31437215134$20K
41679648919$15K
51679139257$10K
61508887993$10K
71073787594$5K
81134662679$3K
91003159369$2K
101659447688$2K
111578755948$1K
121104055037$1K
131992860415$1K
141144576737$589
151790231231$566
161104927383$474
171669517629$363
181457524175$308
191376835918$283
201508942749$281

Showing top 20 of 177 providers billing this code