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#3521 of 11K

L3916

HCPCS Procedure Code

HCPCS code L3916 is the #3,521 most-billed Medicaid procedure code, with $1.6M in payments across 13K claims from 2018–2024. The national median cost per claim is $19.90. Costs vary widely — the 90th percentile is $239.29 per claim, 12.0× the median.

Total Paid

$1.6M

0.00% of all spending

Total Claims

13K

Providers

109

Avg Cost/Claim

$121

National Cost Distribution

How much do providers bill per claim for L3916? Based on 96 providers billing this code nationally.

Median

$19.90

Average

$68.94

Std Dev

$119.34

Max

$535.39

Percentile Distribution (Cost per Claim)

p10
$3.74
p25
$9.69
Median
$19.90
p75
$42.80
p90
$239.29
p95
$366.95
p99
$508.98

50% of providers bill between $9.69 and $42.80 per claim for this code.

90% bill between $3.74 and $239.29.

Top 1% bill above $508.98.

About This Procedure

HCPCS code L3916 was billed by 109 providers across 13K claims, totaling $1.6M in Medicaid payments from 2018–2024. This code was used for 9K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$19.90

Providers Billing

96

National Spending

$1.6M

Avg/Median Ratio

3.46×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for L3916

#ProviderTotal Paid
1Integra Partners Llc

Troy, MI · Orthotic Fitter

$624K
21881790004$360K
31003117508$71K
41831759497$58K
51619113800$52K
61902815665$50K
71598043077$45K
81669844650$42K
91508195066$40K
101417501032$32K
111285025973$25K
121639238819$20K
131821426958$13K
141669635173$11K
151497991954$9K
161205125663$9K
171164736815$7K
181407163710$6K
191407521768$5K
201154849859$5K

Showing top 20 of 109 providers billing this code