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

#6286 of 11K

71111

HCPCS Procedure Code

HCPCS code 71111 is the #6,286 most-billed Medicaid procedure code, with $78K in payments across 4,327 claims from 2018–2024. The national median cost per claim is $13.22. Costs vary widely — the 90th percentile is $84.49 per claim, 6.4× the median.

Total Paid

$78K

0.00% of all spending

Total Claims

4,327

Providers

30

Avg Cost/Claim

$18

National Cost Distribution

How much do providers bill per claim for 71111? Based on 30 providers billing this code nationally.

Median

$13.22

Average

$33.23

Std Dev

$38.23

Max

$156.35

Percentile Distribution (Cost per Claim)

p10
$8.84
p25
$9.20
Median
$13.22
p75
$42.47
p90
$84.49
p95
$107.67
p99
$146.67

50% of providers bill between $9.20 and $42.47 per claim for this code.

90% bill between $8.84 and $84.49.

Top 1% bill above $146.67.

About This Procedure

HCPCS code 71111 was billed by 30 providers across 4,327 claims, totaling $78K in Medicaid payments from 2018–2024. This code was used for 4,119 unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$13.22

Providers Billing

30

National Spending

$78K

Avg/Median Ratio

2.51×

Highly skewed — outlier-driven

Top Providers Billing This Code

Ranked by total Medicaid payments for 71111

#ProviderTotal Paid
11568825545$13K
2Edward W Sparrow Hospital Association

Lansing, MI · Rehabilitation, Substance Use Disorder Unit

$12K
31508856535$11K
41669425658$9K
51740283324$5K
61992701429$5K
71679529978$5K
8Beverly Radiology Medical Group Iii

Los Angeles, CA · Radiology, Diagnostic Radiology

$2K
9Presbyterian Healthcare Services

Albuquerque, NM · Emergency Medicine

$2K
101700865094$2K
111699752923$1K
12Riverside University Health Systems - Medical Center

Moreno Valley, CA · General Acute Care Hospital

$1K
131376719666$1K
141447221742$1K
151801861190$1K
16Montefiore Medical Center

Bronx, NY · General Acute Care Hospital

$807
17The Lowell General Hospital

Lowell, MA · Pharmacy, Institutional Pharmacy

$568
181104896190$541
191720037799$532
201598868655$420

Showing top 20 of 30 providers billing this code