#5984 of 11K

58611

HCPCS Procedure Code

HCPCS code 58611 is the #5,984 most-billed Medicaid procedure code, with $110K in payments across 2,923 claims from 2018–2024. The national median cost per claim is $27.01. Costs vary widely — the 90th percentile is $63.71 per claim, 2.4× the median.

Total Paid

$110K

0.00% of all spending

Total Claims

2,923

Providers

Avg Cost/Claim

$38

National Cost Distribution

How much do providers bill per claim for 58611? Based on 21 providers billing this code nationally.

Median

$27.01

Average

$37.18

Std Dev

$35.52

Max

$145.73

Percentile Distribution (Cost per Claim)

p10

$7.43

p25

$10.96

Median

$27.01

p75

$54.84

p90

$63.71

p95

$95.00

p99

$135.59

50% of providers bill between $10.96 and $54.84 per claim for this code.

90% bill between $7.43 and $63.71.

Top 1% bill above $135.59.

About This Procedure

HCPCS code 58611 was billed by 23 providers across 2,923 claims, totaling $110K in Medicaid payments from 2018–2024. This code was used for 2,584 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$27.01

Providers Billing

National Spending

$110K

Avg/Median Ratio

1.38×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 58611

#	Provider	Total Paid	Cost/Claim	vs Median	Tier
1	1114022431	$58K	$63.71	2.4× median	Top 10%
2	1285928770	$12K	$145.73	5.4× median	Top 1%
3	1649237827	$10K	$57.12	2.1× median	Above 75th
4	1710959135	$8K	$10.96	0.4× median	Below Median
5	1770522856	$6K	$53.97	2.0× median	Above Median
6	1104936988	$5K	$17.40	0.6× median	Below Median
7	1144323395	$2K	$60.79	2.3× median	Above 75th
8	1598807539	$2K	$50.08	1.9× median	Above Median
9	1528456548	$1K	$18.42	0.7× median	Below Median
10	1174744379	$1K	$38.59	1.4× median	Above Median
11	1962731745	$1K	$95.00	3.5× median	Top 10%
12	1184792590	$780	$31.20	1.2× median	Above Median
13	1255459707	$756	$8.80	0.3× median	Below Median
14	1144304817	$658	$54.84	2.0× median	Above 75th
15	1376528729	$498	$14.63	0.5× median	Below Median
16	1255648978	$486	$27.01	1.0× median	Above Median
17	1982708921	$309	$11.46	0.4× median	Below Median
18	Community Physicians Of Indiana Inc Indianapolis, IN · Internal Medicine	$244	$2.11	0.1× median	Below Median
19	1912007873	$147	$10.48	0.4× median	Below Median
20	Community Medical Associates, Inc. Louisville, KY · Clinical Neuropsychologist	$110	$1.04	0.0× median	Below Median

Showing top 20 of 23 providers billing this code

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