#2980 of 11K

11046

HCPCS Procedure Code

HCPCS code 11046 is the #2,980 most-billed Medicaid procedure code, with $2.9M in payments across 74K claims from 2018–2024. The national median cost per claim is $28.70. Costs vary widely — the 90th percentile is $89.02 per claim, 3.1× the median.

Total Paid

$2.9M

0.00% of all spending

Total Claims

74K

Providers

Avg Cost/Claim

$39

National Cost Distribution

How much do providers bill per claim for 11046? Based on 79 providers billing this code nationally.

Median

$28.70

Average

$52.89

Std Dev

$99.13

Max

$672.52

Percentile Distribution (Cost per Claim)

p10

$2.67

p25

$11.44

Median

$28.70

p75

$50.27

p90

$89.02

p95

$171.07

p99

$503.94

50% of providers bill between $11.44 and $50.27 per claim for this code.

90% bill between $2.67 and $89.02.

Top 1% bill above $503.94.

About This Procedure

HCPCS code 11046 was billed by 89 providers across 74K claims, totaling $2.9M in Medicaid payments from 2018–2024. This code was used for 28K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$28.70

Providers Billing

National Spending

$2.9M

Avg/Median Ratio

1.84×

Moderately skewed

Top Providers Billing This Code

Ranked by total Medicaid payments for 11046

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	Newark Beth Israel Medical Center Inc Newark, NJ · General Acute Care Hospital	$923K	$672.52	23.4× median	Top 1%
2	1104018423	$398K	$44.47	1.5× median	Above Median
3	1235333972	$287K	$51.84	1.8× median	Above 75th
4	1679004592	$219K	$30.81	1.1× median	Above Median
5	1083883938	$146K	$25.91	0.9× median	Below Median
6	1275714990	$120K	$10.11	0.4× median	Below Median
7	1114393311	$99K	$53.58	1.9× median	Above 75th
8	Banner - University Medical Center Phoenix Phoenix, AZ · Clinic/Center, Sleep Disorder Diagnostic	$78K	$358.30	12.5× median	Top 10%
9	1437675980	$58K	$33.94	1.2× median	Above Median
10	1942606744	$55K	$30.05	1.0× median	Above Median
11	1063848968	$48K	$15.50	0.5× median	Below Median
12	1699861013	$35K	$40.87	1.4× median	Above Median
13	1306317961	$32K	$72.20	2.5× median	Above 75th
14	Medstar Medical Group Ii Llc Baltimore, MD · General Practice	$26K	$42.18	1.5× median	Above Median
15	1275869802	$25K	$57.82	2.0× median	Above 75th
16	1023085982	$24K	$32.88	1.1× median	Above Median
17	1700813425	$21K	$84.47	2.9× median	Above 75th
18	1861450579	$16K	$221.02	7.7× median	Top 10%
19	Mainegeneral Medical Center Augusta, ME · General Acute Care Hospital	$16K	$112.31	3.9× median	Top 10%
20	1619609039	$15K	$102.87	3.6× median	Top 10%

Showing top 20 of 89 providers billing this code

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