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#2247 of 11K

11730

HCPCS Procedure Code

HCPCS code 11730 is the #2,247 most-billed Medicaid procedure code, with $7.5M in payments across 267K claims from 2018–2024. The national median cost per claim is $24.59. Costs vary widely — the 90th percentile is $74.79 per claim, 3.0× the median.

Total Paid

$7.5M

0.00% of all spending

Total Claims

267K

Providers

708

Avg Cost/Claim

$28

National Cost Distribution

How much do providers bill per claim for 11730? Based on 643 providers billing this code nationally.

Median

$24.59

Average

$32.80

Std Dev

$30.12

Max

$223.96

Percentile Distribution (Cost per Claim)

p10
$3.40
p25
$10.07
Median
$24.59
p75
$48.59
p90
$74.79
p95
$90.97
p99
$126.18

50% of providers bill between $10.07 and $48.59 per claim for this code.

90% bill between $3.40 and $74.79.

Top 1% bill above $126.18.

About This Procedure

HCPCS code 11730 was billed by 708 providers across 267K claims, totaling $7.5M in Medicaid payments from 2018–2024. This code was used for 237K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$24.59

Providers Billing

643

National Spending

$7.5M

Avg/Median Ratio

1.33×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 11730

#ProviderTotal Paid
11922166701$367K
21063480218$299K
3New York Network Ipa Inc

Brooklyn, NY · Exclusive Provider Organization

$240K
41194941161$182K
51568473726$176K
61407002702$171K
71043253230$157K
81891806154$157K
91437433943$154K
101427098227$134K
111659630580$133K
121609029214$116K
131750492773$116K
141841605128$113K
151629082060$102K
16Parcare Community Health Network Inc

Brooklyn, NY · Specialist

$98K
171184186496$95K
181477500155$84K
191740227909$82K
201093730392$82K

Showing top 20 of 708 providers billing this code