Statistical flags indicate unusual patterns — not proof of fraud or wrongdoing. Read our methodology

#6601 of 11K

11980

HCPCS Procedure Code

HCPCS code 11980 is the #6,601 most-billed Medicaid procedure code, with $53K in payments across 944 claims from 2018–2024. The national median cost per claim is $184.45.

Total Paid

$53K

0.00% of all spending

Total Claims

944

Providers

3

Avg Cost/Claim

$56

National Cost Distribution

How much do providers bill per claim for 11980? Based on 2 providers billing this code nationally.

Median

$184.45

Average

$184.45

Std Dev

$186.00

Max

$315.97

Percentile Distribution (Cost per Claim)

p10
$79.23
p25
$118.69
Median
$184.45
p75
$250.21
p90
$289.67
p95
$302.82
p99
$313.34

50% of providers bill between $118.69 and $250.21 per claim for this code.

90% bill between $79.23 and $289.67.

Top 1% bill above $313.34.

About This Procedure

HCPCS code 11980 was billed by 3 providers across 944 claims, totaling $53K in Medicaid payments from 2018–2024. This code was used for 902 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$184.45

Providers Billing

2

National Spending

$53K

Avg/Median Ratio

1.00×

Normal distribution

Provider Coverage

We have 2 providers billing this code in our dataset. Individual provider breakdowns are available for top-spending procedure codes.