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#2774 of 11K

11719

HCPCS Procedure Code

HCPCS code 11719 is the #2,774 most-billed Medicaid procedure code, with $3.7M in payments across 774K claims from 2018–2024. The national median cost per claim is $1.95. Costs vary widely — the 90th percentile is $10.14 per claim, 5.2× the median.

Total Paid

$3.7M

0.00% of all spending

Total Claims

774K

Providers

949

Avg Cost/Claim

$5

National Cost Distribution

How much do providers bill per claim for 11719? Based on 853 providers billing this code nationally.

Median

$1.95

Average

$5.46

Std Dev

$15.35

Max

$224.65

Percentile Distribution (Cost per Claim)

p10
$0.36
p25
$0.97
Median
$1.95
p75
$4.17
p90
$10.14
p95
$20.17
p99
$83.76

50% of providers bill between $0.97 and $4.17 per claim for this code.

90% bill between $0.36 and $10.14.

Top 1% bill above $83.76.

About This Procedure

HCPCS code 11719 was billed by 949 providers across 774K claims, totaling $3.7M in Medicaid payments from 2018–2024. This code was used for 665K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$1.95

Providers Billing

853

National Spending

$3.7M

Avg/Median Ratio

2.80×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for 11719

#ProviderTotal Paid
11760436190$491K
21346337011$225K
3Total Longterm Care Inc.

Aurora, CO · PACE Provider Organization

$170K
41356390918$126K
51598361891$118K
61639770183$103K
71689754046$96K
81609985571$84K
9Rector & Visitors Of The University Of Virginia

Charlottesville, VA · General Acute Care Hospital

$74K
10Our Lady Of The Lake Hospital Inc.

Baton Rouge, LA · General Acute Care Hospital

$68K
111184220485$67K
121770521270$66K
131245780303$63K
141972982007$54K
151487879938$53K
161770514101$46K
171801156815$38K
181548685258$38K
191689613598$38K
20Sun River Health Inc.

Peekskill, NY · Clinic/Center Federally Qualified Health Center (FQHC)

$35K

Showing top 20 of 949 providers billing this code

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