#3874 of 11K

72126

HCPCS Procedure Code

HCPCS code 72126 is the #3,874 most-billed Medicaid procedure code, with $1.1M in payments across 21K claims from 2018–2024. The national median cost per claim is $41.96. Costs vary widely — the 90th percentile is $136.36 per claim, 3.2× the median.

Total Paid

$1.1M

0.00% of all spending

Total Claims

21K

Providers

Avg Cost/Claim

$51

National Cost Distribution

How much do providers bill per claim for 72126? Based on 21 providers billing this code nationally.

Median

$41.96

Average

$58.10

Std Dev

$58.44

Max

$233.48

Percentile Distribution (Cost per Claim)

p10

$6.89

p25

$19.02

Median

$41.96

p75

$66.24

p90

$136.36

p95

$168.36

p99

$220.45

50% of providers bill between $19.02 and $66.24 per claim for this code.

90% bill between $6.89 and $136.36.

Top 1% bill above $220.45.

About This Procedure

HCPCS code 72126 was billed by 24 providers across 21K claims, totaling $1.1M in Medicaid payments from 2018–2024. This code was used for 20K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$41.96

Providers Billing

National Spending

$1.1M

Avg/Median Ratio

1.38×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 72126

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1154335487	$456K	$56.10	1.3× median	Above Median
2	Arrowhead Regional Medical Center Colton, CA · General Acute Care Hospital	$283K	$136.36	3.2× median	Above 75th
3	1336192665	$72K	$57.56	1.4× median	Above Median
4	1740283324	$66K	$30.95	0.7× median	Below Median
5	1023113172	$57K	$33.10	0.8× median	Below Median
6	Norton Hospitals, Inc Louisville, KY · General Acute Care Hospital	$29K	$233.48	5.6× median	Top 1%
7	1720099286	$23K	$103.82	2.5× median	Above 75th
8	Norton Hospitals Inc Louisville, KY · General Acute Care Hospital	$21K	$168.36	4.0× median	Top 10%
9	1104906569	$13K	$6.89	0.2× median	Below Median
10	1376637264	$12K	$5.98	0.1× median	Below Median
11	1730123472	$9K	$47.13	1.1× median	Above Median
12	Rector & Visitors Of The University Of Virginia Charlottesville, VA · General Acute Care Hospital	$5K	$66.24	1.6× median	Above Median
13	1508942681	$4K	$32.26	0.8× median	Below Median
14	1366472029	$3K	$32.71	0.8× median	Below Median
15	1346298528	$3K	$71.75	1.7× median	Above 75th
16	Spectrum Health Hospitals Grand Rapids, MI · General Acute Care Hospital	$2K	$16.00	0.4× median	Below Median
17	1114902509	$1K	$41.96	1.0× median	Below Median
18	1265400378	$921	$43.88	1.0× median	Above Median
19	1144471715	$853	$3.66	0.1× median	Below Median
20	1396765509	$723	$19.02	0.5× median	Below Median

Showing top 20 of 24 providers billing this code

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