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#1386 of 11K

L3216

HCPCS Procedure Code

HCPCS code L3216 is the #1,386 most-billed Medicaid procedure code, with $24.9M in payments across 475K claims from 2018–2024. The national median cost per claim is $56.74. Costs vary widely — the 90th percentile is $115.71 per claim, 2.0× the median.

Total Paid

$24.9M

0.00% of all spending

Total Claims

475K

Providers

206

Avg Cost/Claim

$52

National Cost Distribution

How much do providers bill per claim for L3216? Based on 206 providers billing this code nationally.

Median

$56.74

Average

$66.51

Std Dev

$34.08

Max

$213.13

Percentile Distribution (Cost per Claim)

p10
$33.35
p25
$43.61
Median
$56.74
p75
$84.16
p90
$115.71
p95
$134.44
p99
$179.07

50% of providers bill between $43.61 and $84.16 per claim for this code.

90% bill between $33.35 and $115.71.

Top 1% bill above $179.07.

About This Procedure

HCPCS code L3216 was billed by 206 providers across 475K claims, totaling $24.9M in Medicaid payments from 2018–2024. This code was used for 268K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$56.74

Providers Billing

206

National Spending

$24.9M

Avg/Median Ratio

1.17×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for L3216

#ProviderTotal Paid
1Integra Partners Llc

Troy, MI · Orthotic Fitter

$3.7M
2Podiatry Center Of New Jersey, Llc

Wayne, NJ · Clinic/Center, Podiatric

$2.9M
31386660751$1.1M
41093716334$1.0M
51669635173$1.0M
61003990664$946K
71447211636$944K
81003247297$672K
91700035169$633K
101396920559$611K
111700155017$575K
121659365849$482K
131366590812$433K
141962683235$368K
151235203852$360K
161831174259$356K
171245387943$346K
181326125246$320K
191386755411$307K
201144618794$266K

Showing top 20 of 206 providers billing this code