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#4009 of 11K

11000

HCPCS Procedure Code

HCPCS code 11000 is the #4,009 most-billed Medicaid procedure code, with $937K in payments across 96K claims from 2018–2024. The national median cost per claim is $8.34. Costs vary widely — the 90th percentile is $28.71 per claim, 3.4× the median.

Total Paid

$937K

0.00% of all spending

Total Claims

96K

Providers

119

Avg Cost/Claim

$10

National Cost Distribution

How much do providers bill per claim for 11000? Based on 101 providers billing this code nationally.

Median

$8.34

Average

$12.14

Std Dev

$10.91

Max

$42.52

Percentile Distribution (Cost per Claim)

p10
$1.09
p25
$3.30
Median
$8.34
p75
$20.45
p90
$28.71
p95
$31.13
p99
$38.14

50% of providers bill between $3.30 and $20.45 per claim for this code.

90% bill between $1.09 and $28.71.

Top 1% bill above $38.14.

About This Procedure

HCPCS code 11000 was billed by 119 providers across 96K claims, totaling $937K in Medicaid payments from 2018–2024. This code was used for 83K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$8.34

Providers Billing

101

National Spending

$937K

Avg/Median Ratio

1.46×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 11000

#ProviderTotal Paid
11770590945$246K
21841605128$191K
31558452730$61K
41386643286$41K
51255473286$38K
61093730392$35K
71265464820$27K
81982605697$25K
91194153890$20K
101578562492$17K
111285934737$15K
121487649059$15K
131467563718$14K
141114069044$13K
151023415288$13K
161851347348$11K
171457562175$9K
181750390142$9K
191205387461$8K
201790036275$8K

Showing top 20 of 119 providers billing this code

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