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#825 of 11K

11043

HCPCS Procedure Code

HCPCS code 11043 is the #825 most-billed Medicaid procedure code, with $71.4M in payments across 1.2M claims from 2018–2024. The national median cost per claim is $62.99. Costs vary widely — the 90th percentile is $197.95 per claim, 3.1× the median.

Total Paid

$71.4M

0.01% of all spending

Total Claims

1.2M

Providers

647

Avg Cost/Claim

$58

National Cost Distribution

How much do providers bill per claim for 11043? Based on 632 providers billing this code nationally.

Median

$62.99

Average

$93.07

Std Dev

$104.78

Max

$944.67

Percentile Distribution (Cost per Claim)

p10
$12.07
p25
$30.99
Median
$62.99
p75
$115.59
p90
$197.95
p95
$298.46
p99
$555.60

50% of providers bill between $30.99 and $115.59 per claim for this code.

90% bill between $12.07 and $197.95.

Top 1% bill above $555.60.

About This Procedure

HCPCS code 11043 was billed by 647 providers across 1.2M claims, totaling $71.4M in Medicaid payments from 2018–2024. This code was used for 497K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$62.99

Providers Billing

632

National Spending

$71.4M

Avg/Median Ratio

1.48×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 11043

#ProviderTotal Paid
11104018423$4.4M
21063848968$3.5M
3Newark Beth Israel Medical Center Inc

Newark, NJ · General Acute Care Hospital

$2.9M
41821424789$2.8M
51679004592$2.3M
61083883938$2.3M
71447527320$1.7M
81235333972$1.7M
9Boston Medical Center Corporation

Boston, MA · General Acute Care Hospital

$1.5M
10The Hospital Of Central Connecticut At New Britain General And Bradley

New Britain, CT · General Acute Care Hospital

$1.5M
111255620555$1.4M
121811398811$1.4M
131437675980$1.4M
141346539640$1.4M
151205130911$1.2M
161861450579$961K
17St Elizabeth Medical Center, Inc

Edgewood, KY · Portable X-Ray and/or Other Portable Diagnostic Imaging Supplier

$878K
181447670955$859K
191841599339$841K
201114393311$820K

Showing top 20 of 647 providers billing this code