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#6702 of 11K

11404

HCPCS Procedure Code

HCPCS code 11404 is the #6,702 most-billed Medicaid procedure code, with $47K in payments across 743 claims from 2018–2024. The national median cost per claim is $67.07. Costs vary widely — the 90th percentile is $246.19 per claim, 3.7× the median.

Total Paid

$47K

0.00% of all spending

Total Claims

743

Providers

4

Avg Cost/Claim

$63

National Cost Distribution

How much do providers bill per claim for 11404? Based on 3 providers billing this code nationally.

Median

$67.07

Average

$137.67

Std Dev

$132.90

Max

$290.97

Percentile Distribution (Cost per Claim)

p10
$57.38
p25
$61.01
Median
$67.07
p75
$179.02
p90
$246.19
p95
$268.58
p99
$286.49

50% of providers bill between $61.01 and $179.02 per claim for this code.

90% bill between $57.38 and $246.19.

Top 1% bill above $286.49.

About This Procedure

HCPCS code 11404 was billed by 4 providers across 743 claims, totaling $47K in Medicaid payments from 2018–2024. This code was used for 648 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$67.07

Providers Billing

3

National Spending

$47K

Avg/Median Ratio

2.05×

Highly skewed — outlier-driven

Provider Coverage

We have 3 providers billing this code in our dataset. Individual provider breakdowns are available for top-spending procedure codes.