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#8863 of 11K

W4212

HCPCS Procedure Code

HCPCS code W4212 is the #8,863 most-billed Medicaid procedure code, with $947 in payments across 271 claims from 2018–2024. The national median cost per claim is $1.00. Costs vary widely — the 90th percentile is $16.20 per claim, 16.2× the median.

Total Paid

$947

0.00% of all spending

Total Claims

271

Providers

3

Avg Cost/Claim

$3

National Cost Distribution

How much do providers bill per claim for W4212? Based on 3 providers billing this code nationally.

Median

$1.00

Average

$7.32

Std Dev

$10.98

Max

$20.01

Percentile Distribution (Cost per Claim)

p10
$0.97
p25
$0.98
Median
$1.00
p75
$10.50
p90
$16.20
p95
$18.10
p99
$19.62

50% of providers bill between $0.98 and $10.50 per claim for this code.

90% bill between $0.97 and $16.20.

Top 1% bill above $19.62.

About This Procedure

HCPCS code W4212 was billed by 3 providers across 271 claims, totaling $947 in Medicaid payments from 2018–2024. This code was used for 233 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$1.00

Providers Billing

3

National Spending

$947

Avg/Median Ratio

7.32×

Highly skewed — outlier-driven

Provider Coverage

We have 3 providers billing this code in our dataset. Individual provider breakdowns are available for top-spending procedure codes.

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