#3995 of 11K

11301

HCPCS Procedure Code

HCPCS code 11301 is the #3,995 most-billed Medicaid procedure code, with $944K in payments across 22K claims from 2018–2024. The national median cost per claim is $46.76. Costs vary widely — the 90th percentile is $111.77 per claim, 2.4× the median.

Total Paid

$944K

0.00% of all spending

Total Claims

22K

Providers

Avg Cost/Claim

$43

National Cost Distribution

How much do providers bill per claim for 11301? Based on 63 providers billing this code nationally.

Median

$46.76

Average

$56.88

Std Dev

$37.64

Max

$203.25

Percentile Distribution (Cost per Claim)

p10

$21.73

p25

$29.64

Median

$46.76

p75

$70.78

p90

$111.77

p95

$118.66

p99

$169.34

50% of providers bill between $29.64 and $70.78 per claim for this code.

90% bill between $21.73 and $111.77.

Top 1% bill above $169.34.

About This Procedure

HCPCS code 11301 was billed by 65 providers across 22K claims, totaling $944K in Medicaid payments from 2018–2024. This code was used for 16K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$46.76

Providers Billing

National Spending

$944K

Avg/Median Ratio

1.22×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 11301

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1932237476	$141K	$36.56	0.8× median	Below Median
2	1306982855	$131K	$27.02	0.6× median	Below Median
3	1700184884	$102K	$46.67	1.0× median	Below Median
4	1174565600	$91K	$69.48	1.5× median	Above Median
5	1720089279	$78K	$48.05	1.0× median	Above Median
6	1902867294	$39K	$118.97	2.5× median	Top 10%
7	Optum Medical Care Of New Jersey Pc Secaucus, NJ · Durable Medical Equipment & Medical Supplies	$37K	$102.86	2.2× median	Above 75th
8	1912186917	$33K	$148.55	3.2× median	Top 10%
9	1720110968	$27K	$115.84	2.5× median	Top 10%
10	1407804115	$23K	$94.77	2.0× median	Above 75th
11	1154407856	$22K	$32.10	0.7× median	Below Median
12	1134201460	$22K	$87.37	1.9× median	Above 75th
13	1003263807	$20K	$44.26	0.9× median	Below Median
14	1548692197	$13K	$32.45	0.7× median	Below Median
15	1467070508	$12K	$63.96	1.4× median	Above Median
16	1629263181	$11K	$56.16	1.2× median	Above Median
17	1639398480	$10K	$46.54	1.0× median	Below Median
18	1336121821	$9K	$28.55	0.6× median	Below Median
19	1568649713	$9K	$107.83	2.3× median	Above 75th
20	1982860045	$9K	$21.07	0.5× median	Below Median

Showing top 20 of 65 providers billing this code

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