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#649 of 11K

11721

HCPCS Procedure Code

HCPCS code 11721 is the #649 most-billed Medicaid procedure code, with $115.0M in payments across 11.5M claims from 2018–2024. The national median cost per claim is $8.56. Costs vary widely — the 90th percentile is $22.57 per claim, 2.6× the median.

Total Paid

$115.0M

0.01% of all spending

Total Claims

11.5M

Providers

7K

Avg Cost/Claim

$10

National Cost Distribution

How much do providers bill per claim for 11721? Based on 7K providers billing this code nationally.

Median

$8.56

Average

$11.50

Std Dev

$14.52

Max

$363.86

Percentile Distribution (Cost per Claim)

p10
$1.72
p25
$4.41
Median
$8.56
p75
$14.26
p90
$22.57
p95
$29.04
p99
$63.50

50% of providers bill between $4.41 and $14.26 per claim for this code.

90% bill between $1.72 and $22.57.

Top 1% bill above $63.50.

About This Procedure

HCPCS code 11721 was billed by 7K providers across 11.5M claims, totaling $115.0M in Medicaid payments from 2018–2024. This code was used for 10.3M unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$8.56

Providers Billing

7K

National Spending

$115.0M

Avg/Median Ratio

1.34×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 11721

#ProviderTotal Paid
11083962294$2.5M
21689613598$1.9M
31720037138$1.1M
41730302019$949K
51003066747$757K
61689041055$742K
71831495373$647K
81548685258$640K
9The Metrohealth System

Cleveland, OH · General Acute Care Hospital

$600K
101467845065$581K
111518112499$580K
121225085855$579K
131487879938$550K
141013013002$513K
151497796353$512K
161649212572$508K
171033254255$496K
181073536090$470K
19Bronxcare Health System

Bronx, NY · General Acute Care Hospital

$469K
20Boston Medical Center Corporation

Boston, MA · General Acute Care Hospital

$463K

Showing top 20 of 7K providers billing this code