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#2099 of 11K

11104

HCPCS Procedure Code

HCPCS code 11104 is the #2,099 most-billed Medicaid procedure code, with $9.0M in payments across 82K claims from 2018–2024. The national median cost per claim is $76.74. Costs vary widely — the 90th percentile is $209.01 per claim, 2.7× the median.

Total Paid

$9.0M

0.00% of all spending

Total Claims

82K

Providers

276

Avg Cost/Claim

$110

National Cost Distribution

How much do providers bill per claim for 11104? Based on 271 providers billing this code nationally.

Median

$76.74

Average

$112.96

Std Dev

$123.50

Max

$654.22

Percentile Distribution (Cost per Claim)

p10
$31.57
p25
$54.35
Median
$76.74
p75
$106.67
p90
$209.01
p95
$427.78
p99
$623.06

50% of providers bill between $54.35 and $106.67 per claim for this code.

90% bill between $31.57 and $209.01.

Top 1% bill above $623.06.

About This Procedure

HCPCS code 11104 was billed by 276 providers across 82K claims, totaling $9.0M in Medicaid payments from 2018–2024. This code was used for 75K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$76.74

Providers Billing

271

National Spending

$9.0M

Avg/Median Ratio

1.47×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 11104

#ProviderTotal Paid
1The Cleveland Clinic Foundation

Cleveland, OH · General Acute Care Hospital

$1.0M
2State Of Connecticut

Farmington, CT · Counselor, Professional

$453K
3Brigham & Womens Hospital Inc.

Boston, MA · General Acute Care Hospital

$375K
4Temple University Hospital Inc

Philadelphia, PA · General Acute Care Hospital

$371K
5Umass Memorial Medical Center, Inc.

Worcester, MA · General Acute Care Hospital

$365K
6The Metrohealth System

Cleveland, OH · General Acute Care Hospital

$345K
71134349954$280K
8Rector & Visitors Of The University Of Virginia

Charlottesville, VA · General Acute Care Hospital

$269K
9University Of Washington

Seattle, WA · Clinic/Center, Dental

$259K
101720089279$250K
11Regents Of The University Of Michigan

Ann Arbor, MI · Clinic/Center, End-Stage Renal Disease (ESRD) Treatment

$228K
121306982855$228K
131447244256$227K
141184027104$213K
15Henry Ford Health System

Detroit, MI · General Acute Care Hospital

$187K
161053493288$180K
171154407856$173K
181548489602$124K
191417263922$112K
20Boston Medical Center Corporation

Boston, MA · General Acute Care Hospital

$102K

Showing top 20 of 276 providers billing this code