#3762 of 11K

D7261

HCPCS Procedure Code

HCPCS code D7261 is the #3,762 most-billed Medicaid procedure code, with $1.2M in payments across 5K claims from 2018–2024. The national median cost per claim is $199.74. Costs vary widely — the 90th percentile is $426.52 per claim, 2.1× the median.

Total Paid

$1.2M

0.00% of all spending

Total Claims

Providers

Avg Cost/Claim

$263

National Cost Distribution

How much do providers bill per claim for D7261? Based on 25 providers billing this code nationally.

Median

$199.74

Average

$222.59

Std Dev

$164.73

Max

$477.30

Percentile Distribution (Cost per Claim)

p10

$21.69

p25

$41.09

Median

$199.74

p75

$379.94

p90

$426.52

p95

$435.46

p99

$467.63

50% of providers bill between $41.09 and $379.94 per claim for this code.

90% bill between $21.69 and $426.52.

Top 1% bill above $467.63.

About This Procedure

HCPCS code D7261 was billed by 25 providers across 5K claims, totaling $1.2M in Medicaid payments from 2018–2024. This code was used for 4K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$199.74

Providers Billing

National Spending

$1.2M

Avg/Median Ratio

1.11×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for D7261

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1295271450	$312K	$437.02	2.2× median	Top 10%
2	1295186708	$250K	$422.42	2.1× median	Above 75th
3	1760550552	$223K	$274.30	1.4× median	Above Median
4	1528553070	$170K	$429.25	2.1× median	Top 10%
5	1952562514	$54K	$402.83	2.0× median	Above 75th
6	1952784464	$46K	$189.13	0.9× median	Below Median
7	1639525181	$37K	$110.73	0.6× median	Below Median
8	1700418555	$21K	$404.43	2.0× median	Above 75th
9	1376053389	$17K	$41.09	0.2× median	Below Median
10	1477134112	$17K	$291.13	1.5× median	Above Median
11	1598741043	$13K	$166.99	0.8× median	Below Median
12	1700460763	$10K	$350.48	1.8× median	Above Median
13	1700445194	$9K	$199.74	1.0× median	Below Median
14	1861541518	$7K	$477.30	2.4× median	Top 1%
15	1487012902	$5K	$379.94	1.9× median	Above Median
16	1295135960	$4K	$355.77	1.8× median	Above Median
17	1013225887	$4K	$291.87	1.5× median	Above Median
18	1780718411	$2K	$6.55	0.0× median	Below Median
19	1710266887	$2K	$112.00	0.6× median	Below Median
20	1740349448	$2K	$15.42	0.1× median	Below Median

Showing top 20 of 25 providers billing this code

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