#1507 of 11K

11901

HCPCS Procedure Code

HCPCS code 11901 is the #1,507 most-billed Medicaid procedure code, with $20.8M in payments across 493K claims from 2018–2024. The national median cost per claim is $36.91.

Total Paid

$20.8M

0.00% of all spending

Total Claims

493K

Providers

268

Avg Cost/Claim

$42

National Cost Distribution

How much do providers bill per claim for 11901? Based on 266 providers billing this code nationally.

Median

$36.91

Average

$42.06

Std Dev

$33.27

Max

$301.39

Percentile Distribution (Cost per Claim)

p10

$16.66

p25

$27.19

Median

$36.91

p75

$48.93

p90

$65.35

p95

$71.53

p99

$208.30

50% of providers bill between $27.19 and $48.93 per claim for this code.

90% bill between $16.66 and $65.35.

Top 1% bill above $208.30.

About This Procedure

HCPCS code 11901 was billed by 268 providers across 493K claims, totaling $20.8M in Medicaid payments from 2018–2024. This code was used for 410K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$36.91

Providers Billing

266

National Spending

$20.8M

Avg/Median Ratio

1.14×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 11901

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1134201460	$2.0M	$59.25	1.6× median	Above 75th
2	1134349954	$1.1M	$69.76	1.9× median	Top 10%
3	1619179009	$1.1M	$43.98	1.2× median	Above Median
4	1649258286	$894K	$35.18	1.0× median	Below Median
5	1174565600	$817K	$35.12	1.0× median	Below Median
6	1083610521	$790K	$48.95	1.3× median	Above 75th
7	1215096375	$677K	$47.59	1.3× median	Above Median
8	1336343268	$666K	$63.85	1.7× median	Above 75th
9	1023015245	$608K	$47.00	1.3× median	Above Median
10	1427343391	$591K	$36.76	1.0× median	Below Median
11	1093068611	$574K	$30.10	0.8× median	Below Median
12	1477891901	$492K	$70.25	1.9× median	Top 10%
13	1780977579	$475K	$70.65	1.9× median	Top 10%
14	1821285974	$443K	$21.40	0.6× median	Below Median
15	1679835946	$388K	$26.87	0.7× median	Below Median
16	Ahava Medical And Rehabilitation Center, Llc Brooklyn, NY · Rehabilitation Practitioner	$317K	$265.09	7.2× median	Top 1%
17	1629219522	$313K	$41.78	1.1× median	Above Median
18	1487654596	$299K	$50.37	1.4× median	Above 75th
19	1386719425	$289K	$54.56	1.5× median	Above 75th
20	1962692152	$277K	$37.29	1.0× median	Above Median

Showing top 20 of 268 providers billing this code

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