#3704 of 11K

41115

HCPCS Procedure Code

HCPCS code 41115 is the #3,704 most-billed Medicaid procedure code, with $1.3M in payments across 7,176 claims from 2018–2024. The national median cost per claim is $128.76. Costs vary widely — the 90th percentile is $542.67 per claim, 4.2× the median.

Total Paid

$1.3M

0.00% of all spending

Total Claims

7,176

Providers

Avg Cost/Claim

$182

National Cost Distribution

How much do providers bill per claim for 41115? Based on 31 providers billing this code nationally.

Median

$128.76

Average

$339.32

Std Dev

$671.72

Max

$3,446.80

Percentile Distribution (Cost per Claim)

p10

$61.26

p25

$87.64

Median

$128.76

p75

$186.82

p90

$542.67

p95

$1,398.86

p99

$2,942.39

50% of providers bill between $87.64 and $186.82 per claim for this code.

90% bill between $61.26 and $542.67.

Top 1% bill above $2,942.39.

About This Procedure

HCPCS code 41115 was billed by 31 providers across 7,176 claims, totaling $1.3M in Medicaid payments from 2018–2024. This code was used for 6,204 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$128.76

Providers Billing

National Spending

$1.3M

Avg/Median Ratio

2.64×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for 41115

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1629076518	$806K	$221.97	1.7× median	Above 75th
2	1275809394	$119K	$59.59	0.5× median	Below Median
3	Suny Health Science Center At Syracuse Syracuse, NY · General Acute Care Hospital	$83K	$1,032.27	8.0× median	Top 10%
4	1174571129	$52K	$527.04	4.1× median	Above 75th
5	Maimonides Medical Center Brooklyn, NY · General Acute Care Hospital	$46K	$1,765.45	13.7× median	Top 10%
6	1104234376	$45K	$3,446.80	26.8× median	Top 1%
7	1861592867	$36K	$262.17	2.0× median	Above 75th
8	1265095780	$25K	$61.26	0.5× median	Below Median
9	1518407758	$11K	$124.37	1.0× median	Below Median
10	1154636066	$9K	$126.30	1.0× median	Below Median
11	Dayton Children's Hospital Dayton, OH · General Acute Care Hospital, Children	$9K	$542.67	4.2× median	Top 10%
12	1679851455	$8K	$128.76	1.0× median	Above Median
13	1730939232	$8K	$179.38	1.4× median	Above Median
14	1699819979	$7K	$91.31	0.7× median	Below Median
15	1952525636	$6K	$91.80	0.7× median	Below Median
16	1457364994	$5K	$123.32	1.0× median	Below Median
17	1427007046	$4K	$85.94	0.7× median	Below Median
18	1083824684	$3K	$75.53	0.6× median	Below Median
19	1366685810	$3K	$53.35	0.4× median	Below Median
20	1639285513	$3K	$170.85	1.3× median	Above Median

Showing top 20 of 31 providers billing this code

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