#2202 of 11K

11976

HCPCS Procedure Code

HCPCS code 11976 is the #2,202 most-billed Medicaid procedure code, with $7.9M in payments across 131K claims from 2018–2024. The national median cost per claim is $57.06.

Total Paid

$7.9M

0.00% of all spending

Total Claims

131K

Providers

188

Avg Cost/Claim

$60

National Cost Distribution

How much do providers bill per claim for 11976? Based on 182 providers billing this code nationally.

Median

$57.06

Average

$70.48

Std Dev

$71.91

Max

$600.85

Percentile Distribution (Cost per Claim)

p10

$34.74

p25

$49.22

Median

$57.06

p75

$68.19

p90

$95.24

p95

$113.18

p99

$454.21

50% of providers bill between $49.22 and $68.19 per claim for this code.

90% bill between $34.74 and $95.24.

Top 1% bill above $454.21.

About This Procedure

HCPCS code 11976 was billed by 188 providers across 131K claims, totaling $7.9M in Medicaid payments from 2018–2024. This code was used for 70K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$57.06

Providers Billing

182

National Spending

$7.9M

Avg/Median Ratio

1.24×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 11976

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	Planned Parenthood/orange And San Bernardino Counties, Inc. Orange, CA · Clinic/Center, Ambulatory Family Planning Facility	$3.0M	$53.58	0.9× median	Below Median
2	1285701672	$619K	$583.80	10.2× median	Top 1%
3	1487749495	$211K	$55.44	1.0× median	Below Median
4	1053364034	$198K	$70.73	1.2× median	Above 75th
5	1497847487	$172K	$60.75	1.1× median	Above Median
6	1114264660	$124K	$87.60	1.5× median	Above 75th
7	1982798831	$119K	$52.97	0.9× median	Below Median
8	1730136680	$94K	$26.13	0.5× median	Below Median
9	1083667323	$91K	$67.37	1.2× median	Above Median
10	1598719189	$85K	$76.04	1.3× median	Above 75th
11	1043263189	$83K	$54.45	1.0× median	Below Median
12	1366496838	$80K	$66.35	1.2× median	Above Median
13	1215322797	$80K	$64.14	1.1× median	Above Median
14	1811914674	$78K	$89.13	1.6× median	Above 75th
15	1073608675	$77K	$54.56	1.0× median	Below Median
16	1962456558	$76K	$61.66	1.1× median	Above Median
17	1902109580	$73K	$74.54	1.3× median	Above 75th
18	Unm Hospital Albuquerque, NM · General Acute Care Hospital	$69K	$423.81	7.4× median	Top 10%
19	1801985049	$67K	$65.48	1.1× median	Above Median
20	1710076997	$67K	$64.48	1.1× median	Above Median

Showing top 20 of 188 providers billing this code

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