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

#2796 of 11K

K0821

HCPCS Procedure Code

HCPCS code K0821 is the #2,796 most-billed Medicaid procedure code, with $3.6M in payments across 54K claims from 2018–2024. The national median cost per claim is $86.79. Costs vary widely — the 90th percentile is $322.14 per claim, 3.7× the median.

Total Paid

$3.6M

0.00% of all spending

Total Claims

54K

Providers

55

Avg Cost/Claim

$66

National Cost Distribution

How much do providers bill per claim for K0821? Based on 55 providers billing this code nationally.

Median

$86.79

Average

$144.01

Std Dev

$161.33

Max

$847.28

Percentile Distribution (Cost per Claim)

p10
$26.52
p25
$51.64
Median
$86.79
p75
$189.60
p90
$322.14
p95
$433.84
p99
$737.84

50% of providers bill between $51.64 and $189.60 per claim for this code.

90% bill between $26.52 and $322.14.

Top 1% bill above $737.84.

About This Procedure

HCPCS code K0821 was billed by 55 providers across 54K claims, totaling $3.6M in Medicaid payments from 2018–2024. This code was used for 45K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$86.79

Providers Billing

55

National Spending

$3.6M

Avg/Median Ratio

1.66×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for K0821

#ProviderTotal Paid
11538373998$849K
21790714624$513K
31720196983$368K
41851320774$275K
51487718250$182K
61568491496$181K
71740344522$149K
81669844650$111K
91871710715$99K
101457396376$81K
111215039466$80K
121578531356$78K
131669417531$73K
141205837879$60K
151902205099$57K
161487624193$37K
171568536860$36K
181700402989$34K
191407894348$30K
201376073031$28K

Showing top 20 of 55 providers billing this code