#1803 of 11K

L3219

HCPCS Procedure Code

HCPCS code L3219 is the #1,803 most-billed Medicaid procedure code, with $13.6M in payments across 195K claims from 2018–2024. The national median cost per claim is $76.91.

Total Paid

$13.6M

0.00% of all spending

Total Claims

195K

Providers

Avg Cost/Claim

$70

National Cost Distribution

How much do providers bill per claim for L3219? Based on 52 providers billing this code nationally.

Median

$76.91

Average

$81.29

Std Dev

$32.13

Max

$177.76

Percentile Distribution (Cost per Claim)

p10

$46.05

p25

$61.28

Median

$76.91

p75

$87.87

p90

$108.06

p95

$159.48

p99

$173.73

50% of providers bill between $61.28 and $87.87 per claim for this code.

90% bill between $46.05 and $108.06.

Top 1% bill above $173.73.

About This Procedure

HCPCS code L3219 was billed by 52 providers across 195K claims, totaling $13.6M in Medicaid payments from 2018–2024. This code was used for 101K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$76.91

Providers Billing

National Spending

$13.6M

Avg/Median Ratio

1.06×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for L3219

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	Integra Partners Llc Troy, MI · Orthotic Fitter	$5.3M	$70.00	0.9× median	Below Median
2	1669635173	$1.7M	$60.40	0.8× median	Below Median
3	1669683124	$1.2M	$68.82	0.9× median	Below Median
4	1235203852	$862K	$78.30	1.0× median	Above Median
5	1033351077	$674K	$84.55	1.1× median	Above Median
6	1093716334	$530K	$54.39	0.7× median	Below Median
7	1811345101	$519K	$57.61	0.7× median	Below Median
8	1982717310	$346K	$74.76	1.0× median	Below Median
9	1326125246	$304K	$91.48	1.2× median	Above 75th
10	1477910610	$230K	$91.09	1.2× median	Above 75th
11	1265565758	$229K	$84.10	1.1× median	Above Median
12	1003247297	$187K	$154.25	2.0× median	Top 10%
13	1831759497	$163K	$53.17	0.7× median	Below Median
14	1386660751	$144K	$79.17	1.0× median	Above Median
15	New York Network Ipa Inc Brooklyn, NY · Exclusive Provider Organization	$135K	$88.24	1.1× median	Above 75th
16	1508195066	$110K	$67.95	0.9× median	Below Median
17	1245387943	$103K	$45.47	0.6× median	Below Median
18	1215304878	$102K	$58.43	0.8× median	Below Median
19	1518026772	$101K	$86.37	1.1× median	Above Median
20	1538481114	$83K	$89.70	1.2× median	Above 75th

Showing top 20 of 52 providers billing this code

Related Procedures

L3216$24.9M L3215$17.0M L3221$16.6M L3217$9.2M L3222$5.4M

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