#1228 of 11K

11900

HCPCS Procedure Code

HCPCS code 11900 is the #1,228 most-billed Medicaid procedure code, with $32.4M in payments across 757K claims from 2018–2024. The national median cost per claim is $31.25. Costs vary widely — the 90th percentile is $73.41 per claim, 2.3× the median.

Total Paid

$32.4M

0.00% of all spending

Total Claims

757K

Providers

744

Avg Cost/Claim

$43

National Cost Distribution

How much do providers bill per claim for 11900? Based on 727 providers billing this code nationally.

Median

$31.25

Average

$46.81

Std Dev

$55.73

Max

$479.88

Percentile Distribution (Cost per Claim)

p10

$15.15

p25

$22.47

Median

$31.25

p75

$44.27

p90

$73.41

p95

$176.01

p99

$302.17

50% of providers bill between $22.47 and $44.27 per claim for this code.

90% bill between $15.15 and $73.41.

Top 1% bill above $302.17.

About This Procedure

HCPCS code 11900 was billed by 744 providers across 757K claims, totaling $32.4M in Medicaid payments from 2018–2024. This code was used for 665K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$31.25

Providers Billing

727

National Spending

$32.4M

Avg/Median Ratio

1.50×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 11900

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1134349954	$2.2M	$53.71	1.7× median	Above 75th
2	1134201460	$2.1M	$39.50	1.3× median	Above Median
3	1336343268	$1.2M	$51.73	1.7× median	Above 75th
4	The Cleveland Clinic Foundation Cleveland, OH · General Acute Care Hospital	$727K	$206.60	6.6× median	Top 10%
5	Boston Medical Center Corporation Boston, MA · General Acute Care Hospital	$711K	$169.65	5.4× median	Top 10%
6	1083610521	$645K	$29.10	0.9× median	Below Median
7	1821285974	$625K	$15.20	0.5× median	Below Median
8	Children's Hospital Of Wisconsin, Inc. Milwaukee, WI · Dentist, Pediatric Dentistry	$606K	$116.72	3.7× median	Top 10%
9	1619179009	$508K	$35.44	1.1× median	Above Median
10	1225309586	$491K	$41.67	1.3× median	Above Median
11	1831438662	$477K	$42.28	1.4× median	Above Median
12	1558356741	$459K	$160.30	5.1× median	Top 10%
13	1104229392	$443K	$45.80	1.5× median	Above 75th
14	Montefiore Medical Center Bronx, NY · General Acute Care Hospital	$437K	$295.89	9.5× median	Top 10%
15	1477891901	$433K	$56.70	1.8× median	Above 75th
16	Brigham & Womens Hospital Inc. Boston, MA · General Acute Care Hospital	$404K	$180.63	5.8× median	Top 10%
17	1003082090	$387K	$40.50	1.3× median	Above Median
18	The Metrohealth System Cleveland, OH · General Acute Care Hospital	$370K	$201.30	6.4× median	Top 10%
19	Tufts Medical Center, Inc. Boston, MA · General Acute Care Hospital	$355K	$225.16	7.2× median	Top 10%
20	1336121821	$334K	$21.37	0.7× median	Below Median

Showing top 20 of 744 providers billing this code

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